Healthcare Provider Details

I. General information

NPI: 1235499013
Provider Name (Legal Business Name): LIVIA MACEDO MCCUTCHEON PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIVIA MACEDO PHARM.D.

II. Dates (important events)

Enumeration Date: 05/25/2012
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2830 EASTON AVE
BETHLEHEM PA
18017-4204
US

IV. Provider business mailing address

2830 EASTON AVE
BETHLEHEM PA
18017-4204
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-3555
  • Fax:
Mailing address:
  • Phone: 484-526-3555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11732
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP452135
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number55458
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: