KRYSTAL A WALLIS PHARM D
NPI 1720334329
Pharmacist in Brockport, NY

Active since August 01, 2012
6265 BROCKPORT SPENCERPORT RD, BROCKPORT, NY 14420(585) 637-2341(585) 637-9914 Get Directions Write a Review

NPPES record last updated: June 5, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Krystal A Wallis Pharm D NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRYSTAL A WALLIS PHARM D (NPI 1720334329) is an individual pharmacist in Brockport, New York, licensed in New York (057053) and active in the NPI registry since August 2012.

NPPES Registry Identity

NPI1720334329
Entity TypeIndividualFemale
Primary Taxonomy183500000X
Provider Legal NameKRYSTAL A WALLISCredential: PHARM D
Location Address6265 BROCKPORT SPENCERPORT RDBrockport, NY 14420-2605
Mailing Address6265 Brockport Spencerport RdBrockport, NY 14420-2605 · (585) 637-2341 · Fax (585) 637-9914
Fax(585) 637-9914
Sole ProprietorYes
Enumeration DateAugust 1, 2012
Last NPPES UpdateJune 5, 2013
NPI 1720334329 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in NY · 057053
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
6265 BROCKPORT SPENCERPORT RD, Brockport, NY 14420

Other Names 1

Former Name (1)Krystal A Mellema Pharm D

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
6265 BROCKPORT SPENCERPORT RD
BROCKPORT, NY 14420
Hearing Aid Equipment
6265 BROCKPORT SPENCERPORT RD
BROCKPORT, NY 14420
Pharmacy (Community/Retail Pharmacy)
6265 BROCKPORT SPENCERPORT RD
BROCKPORT, NY 14420
Pharmacist
6265 BROCKPORT SPENCERPORT RD
BROCKPORT, NY 14420
Technician/Technologist (Optician)
6265 BROCKPORT SPENCERPORT RD
BROCKPORT, NY 14420
Technician/Technologist (Optician)
6265 BROCKPORT SPENCERPORT RD
BROCKPORT, NY 14420
Hearing Instrument Specialist
6265 BROCKPORT SPENCERPORT RD
BROCKPORT, NY 14420
Pharmacist
6265 BROCKPORT SPENCERPORT RD
BROCKPORT, NY 14420

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Krystal Wallis's NPI number?

The NPI number for Krystal Wallis is 1720334329. It was assigned to this individual provider in the NPPES registry on August 1, 2012. The provider is also known as Krystal A Mellema Pharm D.

Where is Krystal Wallis located?

Krystal Wallis practices at 6265 Brockport Spencerport Rd, Brockport, NY 14420. The listed phone number is (585) 637-2341.

What is Krystal Wallis's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Krystal Wallis was last updated on June 5, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.