Monika M Baltaziuk
Individual provider Active NPI Pharmacist · Tonawanda, NY
NPI 1497062855 · NPPES record last updated Sep 8, 2010
Key facts
- NPI
- 1497062855
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 054661 (NY)
- Practice address
- 621 Delaware St
Tonawanda, NY 14150-5359 - Phone
- (716) 743-8037
- NPI assigned
- Sep 8, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054661 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rite Aid | Pharmacist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 054661 | NY | Yes |
Addresses
Primary practice location
621 Delaware St
Tonawanda, NY 14150-5359
Mailing address
399 Stony Rd
Lancaster, NY 14086-1520
Phone (716) 683-5405
Other providers in Tonawanda, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.