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General NPI Number Information
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NPI Number | 1982871737
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Entity Type | Individual
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Provider Name | JESSICA ELLEN O'KELL PHARM D
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Gender | Female
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 2320 GRAND ISLAND BLVD
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City | GRAND ISLAND
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State | NY
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Zip | 14072-3113
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Country | US
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Telephone | 716-775-0691
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Fax | 716-775-0697
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Provider Business Mailing Address
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Address Line | 46 BRIARWOOD LN
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City | GRAND ISLAND
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State | NY
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Zip | 14072-1972
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Country | US
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Telephone | 716-775-1600
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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 | 49309
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License Number State | NY
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