Individual provider Active NPI

Joelle J Pawlicki, R.PH.

  • Pharmacist
  • Manlius, NY
National Provider Identifier
1306108147
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
041483 Issued in NY
Practice address
119 W Seneca St
Manlius, NY 13104-3400
Phone
(315) 682-1918
Fax
(315) 682-5055
NPI assigned
Jun 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 041483 NY Primary
Pharmacist 183500000X PS39961 FL

Addresses

Primary practice location

119 W Seneca St
Manlius, NY 13104-3400

Mailing address

119 W Seneca St
Manlius, NY 13104-3400
Phone (315) 682-1918

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
PS39961FLMDPharmacist
041483NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1306108147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 W SENECA ST",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131043400",
            "telephone_number": "315-682-1918",
            "fax_number": "315-682-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 W SENECA ST",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131043400",
            "telephone_number": "315-682-1918",
            "fax_number": "315-682-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLICKI",
        "first_name": "JOELLE",
        "middle_name": "J",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "041483",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS39961",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manlius, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; 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.