Siobhan Ann Hacker
Individual provider Active NPI Pharmacist · Springville, NY
NPI 1992286264 · NPPES record last updated Aug 24, 2018
Key facts
- NPI
- 1992286264
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 064459 (NY)
- Practice address
- 40 W Main St
Springville, NY 14141-1014 - Phone
- (716) 592-2836
- NPI assigned
- Aug 24, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 064459 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rite Aid of New York Inc | Past | Accepting new patients | |
| Rite Aid of New York Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 064459 | NY | Yes |
Addresses
Primary practice location
40 W Main St
Springville, NY 14141-1014
Mailing address
25 S Lincoln Ave Apt 211
Orchard Park, NY 14127-2656
Phone (716) 572-1762
Other providers in Springville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2018. 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.