Provider Demographics
NPI:1871047951
Name:INGLIS, NICHOLAS ANDREW (PHARM D)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ANDREW
Last Name:INGLIS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 FARGO AVE
Mailing Address - Street 2:APARTMENT #2
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14201-1138
Mailing Address - Country:US
Mailing Address - Phone:732-485-7583
Mailing Address - Fax:
Practice Address - Street 1:112 FARGO AVE
Practice Address - Street 2:APARTMENT #2
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14201-1138
Practice Address - Country:US
Practice Address - Phone:732-485-7583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-07
Last Update Date:2016-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062058183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist