MEDICARE: JILL R SCIORTINO RPH

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	047615	NY
2	183500000X	Pharmacist	45912	TX

General Provider Information

NPI Number	:	1407973209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL R SCIORTINO RPH

Provider Business Mailing Address
First Line	:	5300 PARTRIDGE HILL CT
Second Line	:
City	:	GREAT VALLEY
State	:	NY
Zip	:	14741
Country	:	US
Telephone Number	:	716-353-3119
Fax Number	:

Provider Business Practice Location Address
First Line	:	5300 PARTRIDGE HILL
Second Line	:
City	:	GREAT VALLEY
State	:	NY
Zip	:	14741
Country	:	US
Telephone Number	:	716-353-3119
Fax Number	:

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

Provider Enumeration Date	:	03/25/2007
Last Update Date	:	06/19/2012

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