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NPI Code Detail

MEDICARE: MARY CATHERINE NILES PHARMD

MEDICARE: MARY CATHERINE NILES PHARMD
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
1183500000XPharmacist049745NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1049745OTHERNYPHARMACIST LICENSE

General Provider Information

NPI Number : 1700058823
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY CATHERINE NILES PHARMD
Provider Business Mailing Address
First Line : 1500 BROOKS AVE
Second Line : ATTN: PHARMACY MANAGER
City : ROCHESTER
State : NY
Zip : 14624-3512
Country : US
Telephone Number : 585-239-2020
Fax Number : 585-239-2015
Provider Business Practice Location Address
First Line : 3177 LATTA RD
Second Line : ATTN: PHARMACY MANAGER
City : ROCHESTER
State : NY
Zip : 14612-3094
Country : US
Telephone Number : 585-225-6111
Fax Number : 585-723-6289
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2008
Last Update Date : 12/05/2008

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Directions to “ MARY CATHERINE NILES PHARMD” Practice Location

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