MEDICARE: NICOLE MARIE PELECH PHARM.D.

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	051800-1	NY

General Provider Information

NPI Number	:	1326228305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MARIE PELECH PHARM.D.

Provider Business Mailing Address
First Line	:	94 MAIN ST
Second Line	:
City	:	SOUTH GLENS FALLS
State	:	NY
Zip	:	12803-4842
Country	:	US
Telephone Number	:	518-792-5575
Fax Number	:	518-747-9451

Provider Business Practice Location Address
First Line	:	94 MAIN ST
Second Line	:
City	:	SOUTH GLENS FALLS
State	:	NY
Zip	:	12803-4842
Country	:	US
Telephone Number	:	518-792-5575
Fax Number	:	518-792-6415

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

Provider Enumeration Date	:	11/07/2007
Last Update Date	:	11/14/2022

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