Healthcare Provider Details

I. General information

NPI: 1053258269
Provider Name (Legal Business Name): ANN MARIE RAPONE
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: ANN MARIE FAVA

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 STEVENSON MILL RD STE 400
CORAOPOLIS PA
15108-2505
US

IV. Provider business mailing address

1210 OLD PRINCETON RD
NEW CASTLE PA
16101-6247
US

V. Phone/Fax

Practice location:
  • Phone: 855-726-8479
  • Fax:
Mailing address:
  • Phone: 724-674-7263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP037839R
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: