Individual provider Active NPI

Tracy Elizabeth Ardalan, RPH

  • Pharmacist
  • Buffalo, NY
National Provider Identifier
1306029772
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
039450 Issued in NY
Practice address
1979 Seneca St
Buffalo, NY 14210-2352
Phone
(716) 827-4900
Fax
(716) 827-4901
NPI assigned
Dec 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 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 039450 NY Primary

Addresses

Primary practice location

1979 Seneca St
Buffalo, NY 14210-2352

Mailing address

1979 Seneca St
Buffalo, NY 14210-2352
Phone (716) 827-4900

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
039450NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1197072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1306029772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1979 SENECA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142102352",
            "telephone_number": "716-827-4900",
            "fax_number": "716-827-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1979 SENECA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142102352",
            "telephone_number": "716-827-4900",
            "fax_number": "716-827-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDALAN",
        "first_name": "TRACY",
        "middle_name": "ELIZABETH",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-08",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "039450",
            "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 Mar 7, 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.