Healthcare Provider Details

I. General information

NPI: 1710629407
Provider Name (Legal Business Name): KELLY LYNN SZATKOWSKI PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 04/12/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3177 LATTA RD
ROCHESTER NY
14612-3094
US

IV. Provider business mailing address

15 RICHFIELD DR
HILTON NY
14468-9022
US

V. Phone/Fax

Practice location:
  • Phone: 585-225-6111
  • Fax:
Mailing address:
  • Phone: 585-227-4574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number049235
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: