Healthcare Provider Details

I. General information

NPI: 1639170673
Provider Name (Legal Business Name): JEFFREY SCOTT ZALESKI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 RICHMOND AVE M/C 119
BATAVIA NY
14020-1288
US

IV. Provider business mailing address

13355 CHERRY TREE LANE
ALDEN NY
14004-1038
US

V. Phone/Fax

Practice location:
  • Phone: 585-279-1110
  • Fax: 585-297-1112
Mailing address:
  • Phone: 716-937-0199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number048043
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: