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NPI Code Detail

MEDICARE: DR. KELLY LYNN SIRIANNO PHARMD

MEDICARE: DR. KELLY LYNN SIRIANNO 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
1183500000XPharmacist048179NY

General Provider Information

NPI Number : 1942411970
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KELLY LYNN SIRIANNO PHARMD
Provider Business Mailing Address
First Line : 2317 TIMBERLINE DR
Second Line :
City : MACEDON
State : NY
Zip : 14502-9120
Country : US
Telephone Number : 315-986-8487
Fax Number :
Provider Business Practice Location Address
First Line : 709 W UNION ST
Second Line :
City : NEWARK
State : NY
Zip : 14513-1357
Country : US
Telephone Number : 315-332-0193
Fax Number : 315-332-0197
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2007
Last Update Date : 07/08/2007

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