Healthcare Provider Details

I. General information

NPI: 1003657016
Provider Name (Legal Business Name): TOPS MARKETS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5175 BROADWAY
DEPEW NY
14043-4025
US

IV. Provider business mailing address

461 NOTT ST
SCHENECTADY NY
12308-1812
US

V. Phone/Fax

Practice location:
  • Phone: 716-515-3435
  • Fax: 855-331-9010
Mailing address:
  • Phone: 518-379-1618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: SCOTT GUISINGER
Title or Position: VP PHARMACY
Credential:
Phone: 518-379-2409