Peter K Illig, RPH PHARMACIST

Primary specialty

PharmacistTaxonomy code 183500000X

License

033353-1 Issued in NY

Practice address

445 Broad St
Salamanca, NY 14779-1424

Phone

(716) 945-2140

Fax

(716) 945-0857

NPI assigned

Apr 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

• Ellicottville Pharmacy Inc

  dba Park Pharmacy

  • Community/Retail Pharmacy
  • Salamanca, NY
  • NPI 1235211020
  Authorized official Same address or phone

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275758096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 MEMORIAL DR",
            "city": "CATTARAUGUS",
            "state": "NY",
            "postal_code": "147191234",
            "telephone_number": "716-257-3723",
            "fax_number": "716-945-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 BROAD ST",
            "city": "SALAMANCA",
            "state": "NY",
            "postal_code": "147791424",
            "telephone_number": "716-945-2140",
            "fax_number": "716-945-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLIG",
        "first_name": "PETER",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "RPH  PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "033353-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE PHARMACY LICENSE",
            "identifier": "033353-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neandra Jean Haynoski, LPN
• Cassandra Hinman
• Judith Anne Hoag, LPN
• Lauren Kathlene Hunt, DPT
• Anne Huselstein, RPH
• Stephen J Illig, DDS
• Erica Ashley Jeter
• John, Ross L., Sr. Native Pharmaceutical Direct (Native Pharmaceutical Direct)
• Michael Kalsman, MD
• Emily M Karn, PA

• Pharmacist in Salamanca, NY
• Providers in Salamanca, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.