MEDICARE: DR. ROBERTA DEPASQUALE PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP441103	PA
2	183500000X	Pharmacist	RP1000095	PA

General Provider Information

NPI Number	:	1154571909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERTA DEPASQUALE PHARMD

Provider Business Mailing Address
First Line	:	2021 WHARTON ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-1915
Country	:	US
Telephone Number	:	412-488-1802
Fax Number	:	412-488-1169

Provider Business Practice Location Address
First Line	:	2021 WHARTON ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-1915
Country	:	US
Telephone Number	:	412-488-1802
Fax Number	:	412-488-1169

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2008
Last Update Date	:	09/29/2008

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