Individual provider Active NPI

Mary L Pazderski, RPH

  • Pharmacist
  • West Seneca, NY
National Provider Identifier
1356551436
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
042349-1 Issued in NY
Practice address
40 Gardenville Pkwy W
Suite 104
West Seneca, NY 14224-1387
Phone
(716) 675-3784
Fax
(716) 675-7777
NPI assigned
May 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 042349-1 NY Primary

Addresses

Primary practice location

40 Gardenville Pkwy W
Suite 104
West Seneca, NY 14224-1387

Mailing address

139 Carla LN
West Seneca, NY 14224-4467
Phone (716) 677-4694

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
042349-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356551436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 CARLA LN",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142244467",
            "telephone_number": "716-677-4694",
            "fax_number": "716-675-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 GARDENVILLE PKWY W",
            "address_2": "SUITE 104",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142241387",
            "telephone_number": "716-675-3784",
            "fax_number": "716-675-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAZDERSKI",
        "first_name": "MARY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "042349-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

  • 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.