NPIMap

Organization Active NPI

Rite Aid Pharmacy

  • Pharmacist
  • Buffalo, NY
National Provider Identifier
1508247131
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
059357 Issued in NY
Legal business name
RITE AID PHARMACY
Practice address
284 Connecticut St
Buffalo, NY 14213-2542
Phone
(716) 881-4007
NPI assigned
Jun 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Authorized official

Name
Dr. Andrew Michael Lysogorski, PHARMD
Title
Staff Pharmacist
Phone
(518) 641-2828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 059357 NY Primary

Addresses

Primary practice location

284 Connecticut St
Buffalo, NY 14213-2542

Mailing address

346 Connecticut St
Apt 302
Buffalo, NY 14213-2900
Phone (716) 881-4007

Other identifiers 1

IdentifierTypeStateIssuer
1576493MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Rite Aid of New York Inc32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1508247131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 CONNECTICUT ST",
            "address_2": "APT 302",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142132900",
            "telephone_number": "716-881-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 CONNECTICUT ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142132542",
            "telephone_number": "716-881-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITE AID PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "LYSOGORSKI",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "STAFF PHARMACIST",
        "authorized_official_telephone_number": "518-641-2828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "059357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1576493",
            "state": "NY"
        }
    ],
    "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 Jun 9, 2015; 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.