Healthcare Provider Details

I. General information

NPI: 1346154101
Provider Name (Legal Business Name): EMILY CHRISTINE FUKAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NORTHTOWNE SQ
GIBSONIA PA
15044-7523
US

IV. Provider business mailing address

400 NORTHTOWNE SQ
GIBSONIA PA
15044-7523
US

V. Phone/Fax

Practice location:
  • Phone: 724-443-7979
  • Fax:
Mailing address:
  • Phone: 724-443-7979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP460646
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: