Jonathan Thomas Blackman, PHARMD
Individual provider Active NPI Pharmacist · Pittsford, NY
NPI 1548549686 · NPPES record last updated Aug 8, 2011
Key facts
- NPI
- 1548549686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 055827 (NY)
- Practice address
- 3 Ten Eyke Cir
Pittsford, NY 14534-3120 - Phone
- (585) 394-5350
- NPI assigned
- Aug 8, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055827 | NY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 055827 | NY | Yes |
Addresses
Primary practice location
3 Ten Eyke Cir
Pittsford, NY 14534-3120
Mailing address
3 Ten Eyke Cir
Pittsford, NY 14534-3120
Other providers in Pittsford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2011. 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.