Active NPI
Gregory Micoli
- Pharmacist
- Buffalo, NY
National Provider Identifier
1003466905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26617
- Practice address
- 3495 Bailey Ave
Buffalo, NY 14215-1129 - Phone
- (716) 834-9200
- NPI assigned
- Sep 13, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26617 | NC | Primary |
Addresses
Primary practice location
3495 Bailey Ave
Buffalo, NY 14215-1129
Mailing address
771 Thomas Fox Dr W
North Tonawanda, NY 14120-2933
Phone (716) 935-0259
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26617 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568332800000",
"number": "1003466905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "771 THOMAS FOX DR W",
"city": "NORTH TONAWANDA",
"state": "NY",
"postal_code": "141202933",
"telephone_number": "716-935-0259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3495 BAILEY AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142151129",
"telephone_number": "716-834-9200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICOLI",
"first_name": "GREGORY",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-13",
"last_updated": "2019-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "26617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.