Healthcare Provider Details

I. General information

NPI: 1861916744
Provider Name (Legal Business Name): JARED SCOTT AIKEN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 08/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 S MAIN ST
JAMESTOWN NY
14701-6633
US

IV. Provider business mailing address

55 E ELMWOOD AVE
FALCONER NY
14733-1450
US

V. Phone/Fax

Practice location:
  • Phone: 716-664-2650
  • Fax: 716-483-3460
Mailing address:
  • Phone: 716-450-1288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number063045
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: