Individual provider Active NPI

Justin Saul Taylor, PHARM D

  • Pharmacist
  • Niagara Falls, NY
National Provider Identifier
1912665068
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
066308 Issued in NY
Practice address
2578 Niagara Falls Blvd
Niagara Falls, NY 14304-4681
Phone
(716) 731-3500
Fax
(716) 731-3501
NPI assigned
Dec 6, 2021
Last updated
Jun 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 066308 NY Primary

Addresses

Primary practice location

2578 Niagara Falls Blvd
Niagara Falls, NY 14304-4681

Mailing address

1066 Pioneer Dr
North Tonawanda, NY 14120-2928
Phone (716) 628-9002

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
066308NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Park Pharmacy Inc CurrentSince Jun 9, 2024 Accepting new patients
Eckerd Corporation PastSince Dec 1, 2021 Accepting new patients
Eckerd Corporation PastSince Dec 1, 2021 Accepting new patients

Locations

2578 Niagara Falls Blvd
Niagara Falls, NY 14304
Phone (716) 731-3500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1912665068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1066 PIONEER DR",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202928",
            "telephone_number": "716-628-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2578 NIAGARA FALLS BLVD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143044681",
            "telephone_number": "716-731-3500",
            "fax_number": "716-731-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JUSTIN",
        "middle_name": "SAUL",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-06",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "066308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.