Provider Demographics
NPI:1063677540
Name:PSAILA, BART ROBERT (BSPHARMACY)
Entity Type:Individual
Prefix:MR
First Name:BART
Middle Name:ROBERT
Last Name:PSAILA
Suffix:
Gender:M
Credentials:BSPHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GREENWOOD PARK
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-2912
Mailing Address - Country:US
Mailing Address - Phone:585-249-0871
Mailing Address - Fax:585-249-0871
Practice Address - Street 1:53 W MAIN ST
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-1198
Practice Address - Country:US
Practice Address - Phone:585-924-7970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021716-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist