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General NPI Number Information
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NPI Number | 1194482000
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Entity Type | Individual
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Provider Name | ELVIS VELJACIC
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Gender | Male
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Dates
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Enumeration Date | 11/27/2021
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Last Update Date | 11/27/2021
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Provider Practice Location Address
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Address Line | 45 BECKER RD STE D
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City | WEST HENRIETTA
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State | NY
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Zip | 14586-9211
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Country | US
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Telephone | 585-486-4367
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Fax |
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Provider Business Mailing Address
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Address Line | 50 FAIRWOOD DR APT 110
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City | ROCHESTER
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State | NY
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Zip | 14623-4950
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Country | US
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Telephone | 315-941-8643
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | I068060-01
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License Number State | NY
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