Provider Demographics
NPI:1215147376
Name:PRIOR, MARK CHRISTOPHER (DC PHARM D)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:CHRISTOPHER
Last Name:PRIOR
Suffix:
Gender:M
Credentials:DC PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 COMO PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-4454
Mailing Address - Country:US
Mailing Address - Phone:716-685-4288
Mailing Address - Fax:
Practice Address - Street 1:4721 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-4898
Practice Address - Country:US
Practice Address - Phone:716-668-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2008-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010264111N00000X
NY051950183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No183500000XPharmacy Service ProvidersPharmacist