MEDICARE: JEFFREY ALAN MACDONALD JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	066548	NY

General Provider Information

NPI Number	:	1811859929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY ALAN MACDONALD JR.

Provider Business Mailing Address
First Line	:	25 COHOES AVE
Second Line	:
City	:	GREEN ISLAND
State	:	NY
Zip	:	12183-1562
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 COHOES AVE
Second Line	:
City	:	GREEN ISLAND
State	:	NY
Zip	:	12183-1562
Country	:	US
Telephone Number	:	315-489-2206
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2025
Last Update Date	:	11/26/2025

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