Healthcare Provider Details

I. General information

NPI: 1255936746
Provider Name (Legal Business Name): GIANNA MARIA SANTANGELO PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 W EAGLE RD
HAVERTOWN PA
19083-2234
US

IV. Provider business mailing address

264 WESTBROOK DR
CLIFTON HEIGHTS PA
19018-1117
US

V. Phone/Fax

Practice location:
  • Phone: 610-853-1768
  • Fax:
Mailing address:
  • Phone: 610-888-7191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP454264
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: