Healthcare Provider Details

I. General information

NPI: 1144156381
Provider Name (Legal Business Name): JOHN NICHOLAS O'DONNELL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 NEW SCOTLAND AVE
ALBANY NY
12208-3478
US

IV. Provider business mailing address

106 NEW SCOTLAND AVE
ALBANY NY
12208-3492
US

V. Phone/Fax

Practice location:
  • Phone: 508-208-4969
  • Fax:
Mailing address:
  • Phone: 518-694-7203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835I0206X
TaxonomyInfectious Diseases Pharmacist
License Number062648
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: