Active NPI
Nicholas Donofrio
- Pharmacist
- Syracuse, NY
National Provider Identifier
1104411255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 066874
- Practice address
- 515 Stewart Dr
Syracuse, NY 13212-3417 - Phone
- (866) 582-8612
- NPI assigned
- Mar 1, 2021
- 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 | 066874 | NY | Primary |
Addresses
Primary practice location
515 Stewart Dr
Syracuse, NY 13212-3417
Mailing address
146 W Bayard St
Seneca Falls, NY 13148-1714
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 |
|---|---|---|---|
| 066874 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614556800000",
"number": "1104411255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "146 W BAYARD ST",
"city": "SENECA FALLS",
"state": "NY",
"postal_code": "131481714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 STEWART DR",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132123417",
"telephone_number": "866-582-8612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONOFRIO",
"first_name": "NICHOLAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-01",
"last_updated": "2021-03-01",
"certification_date": "2021-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "066874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.