Provider Demographics
NPI:1508028465
Name:GIES, DARRYL (RPH)
Entity Type:Individual
Prefix:
First Name:DARRYL
Middle Name:
Last Name:GIES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 BROOKS AVE
Mailing Address - Street 2:ATTN: PHARMACY OFFICE
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-3512
Mailing Address - Country:US
Mailing Address - Phone:585-239-2020
Mailing Address - Fax:585-239-2015
Practice Address - Street 1:2851 BROADWAY ST
Practice Address - Street 2:ATTN: CENTRAL FILL MANAGER
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14227
Practice Address - Country:US
Practice Address - Phone:716-894-5671
Practice Address - Fax:716-894-7047
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046239183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY046239OtherPHARMACIST LICENSE NUMBER