Healthcare Provider Details

I. General information

NPI: 1952947459
Provider Name (Legal Business Name): CATHERINE ANN WISNIEWSKI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 MAIN ST
DENVER PA
17517-1448
US

IV. Provider business mailing address

334 MAIN ST
DENVER PA
17517-1448
US

V. Phone/Fax

Practice location:
  • Phone: 717-336-2292
  • Fax: 717-336-2219
Mailing address:
  • Phone: 717-336-2292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRP444993
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: