Active NPI
Evan Taylor Slichko, PHARM D
- Pharmacist
- Glens Falls, NY
National Provider Identifier
1306200217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 048593
- Practice address
- 100 Park St
Glens Falls, NY 12801-4413 - Phone
- (518) 926-2500
- NPI assigned
- Apr 6, 2016
- Sex
- Male
- Sole proprietor
- No
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 | 048593 | NY | Primary |
Addresses
Primary practice location
100 Park St
Glens Falls, NY 12801-4413
Mailing address
100 Park St
Glens Falls, NY 12801-4413
Phone (518) 926-2500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 048593 | Other | NY | PHARMACY LICENSE |
| 136392 | Other | NABP E PROFILE ID |
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048593 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459900800000",
"number": "1306200217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 PARK ST",
"city": "GLENS FALLS",
"state": "NY",
"postal_code": "128014413",
"telephone_number": "518-926-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 PARK ST",
"city": "GLENS FALLS",
"state": "NY",
"postal_code": "128014413",
"telephone_number": "518-926-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLICHKO",
"first_name": "EVAN",
"middle_name": "TAYLOR",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-06",
"last_updated": "2016-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "048593",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE",
"identifier": "048593",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP E PROFILE ID",
"identifier": "136392",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Glens Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.