Healthcare Provider Details

I. General information

NPI: 1861945289
Provider Name (Legal Business Name): LYNDSIE DELPRATO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2016
Last Update Date: 08/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 W 26TH ST
ERIE PA
16508-1803
US

IV. Provider business mailing address

1247 BELLE VILLAGE DR S
ERIE PA
16509-7601
US

V. Phone/Fax

Practice location:
  • Phone: 814-452-4012
  • Fax:
Mailing address:
  • Phone: 724-288-8345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP450759
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: