Healthcare Provider Details

I. General information

NPI: 1811776487
Provider Name (Legal Business Name): CARSON JAMES SINISKO PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CRANBERRY WOODS DR
CRANBERRY TOWNSHIP PA
16066-5213
US

IV. Provider business mailing address

500 KERRY CT APT 5321
MC MURRAY PA
15317-5057
US

V. Phone/Fax

Practice location:
  • Phone: 800-553-2324
  • Fax:
Mailing address:
  • Phone: 570-202-6344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP459649
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: