MEDICARE: MALLORI ANNE OCHTERSKI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	063379	NY

General Provider Information

NPI Number	:	1104344092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALLORI ANNE OCHTERSKI

Provider Business Mailing Address
First Line	:	110 WOODSIDE DR
Second Line	:
City	:	ELMA
State	:	NY
Zip	:	14059-9202
Country	:	US
Telephone Number	:	716-341-3067
Fax Number	:

Provider Business Practice Location Address
First Line	:	4060 N BUFFALO ST
Second Line	:
City	:	ORCHARD PARK
State	:	NY
Zip	:	14127-2444
Country	:	US
Telephone Number	:	716-662-4401
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2017
Last Update Date	:	07/21/2022

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Directions to “ MALLORI ANNE OCHTERSKI ” Practice Location

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