Healthcare Provider Details

I. General information

NPI: 1689224313
Provider Name (Legal Business Name): JILLIAN MARY OWENS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2019
Last Update Date: 09/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 ABBOTT RD
BUFFALO NY
14220-2039
US

IV. Provider business mailing address

50 SAN FERNANDO LN
EAST AMHERST NY
14051-2234
US

V. Phone/Fax

Practice location:
  • Phone: 716-826-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number065538
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: