Healthcare Provider Details

I. General information

NPI: 1679053573
Provider Name (Legal Business Name): TAYLOR ANN TOOMEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2018
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 TARBELL RD STE 103
SYRACUSE NY
13206-1348
US

IV. Provider business mailing address

3642 WHISPERING WOODS
BALDWINSVILLE NY
13027
US

V. Phone/Fax

Practice location:
  • Phone: 888-843-2040
  • Fax:
Mailing address:
  • Phone: 315-876-3472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number064386
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberI064386
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: