Individual provider Active NPI

Mallori Anne Ochterski

  • Pharmacist
  • Orchard Park, NY
National Provider Identifier
1104344092
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
063379 Issued in NY
Practice address
4060 N Buffalo St
Orchard Park, NY 14127-2444
Phone
(716) 662-4401
NPI assigned
Aug 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 063379 NY Primary

Addresses

Primary practice location

4060 N Buffalo St
Orchard Park, NY 14127-2444

Mailing address

110 Woodside Dr
Elma, NY 14059-9202
Phone (716) 341-3067

Other practice location 1

110 Woodside Dr
Elma, NY 14059-9202
Phone (716) 341-3067

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

LicenseStateTypeSpecialty
063379NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Eckerd Corporation Past Accepting new patients
Eckerd Corporation Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104344092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 WOODSIDE DR",
            "city": "ELMA",
            "state": "NY",
            "postal_code": "140599202",
            "telephone_number": "716-341-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 N BUFFALO ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272444",
            "telephone_number": "716-662-4401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Woodside Dr",
            "address_purpose": "LOCATION",
            "city": "Elma",
            "state": "NY",
            "postal_code": "140599202",
            "country_code": "US",
            "telephone_number": "716-341-3067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OCHTERSKI",
        "first_name": "MALLORI",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "063379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.