Individual provider Active NPI

Mark Stahl, PHARM. D

  • Pharmacist
  • Gasport, NY
National Provider Identifier
1528319936
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
052840 Issued in NY
Practice address
5268 Gasport Rd
Gasport, NY 14067-9352
Phone
(716) 735-3261
Fax
(716) 735-3351
NPI assigned
Sep 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 052840 NY Primary

Addresses

Primary practice location

5268 Gasport Rd
Gasport, NY 14067-9352

Mailing address

5268 Gasport Rd
Gasport, NY 14067-9352

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

LicenseStateTypeSpecialty
052840NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1528319936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5268 GASPORT RD",
            "city": "GASPORT",
            "state": "NY",
            "postal_code": "140679352",
            "fax_number": "716-735-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5268 GASPORT RD",
            "city": "GASPORT",
            "state": "NY",
            "postal_code": "140679352",
            "telephone_number": "716-735-3261",
            "fax_number": "716-735-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHL",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PHARM. D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-25",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "052840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gasport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.