Healthcare Provider Details

I. General information

NPI: 1023662038
Provider Name (Legal Business Name): JOAN RAIMONDO ZILNER R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2019
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 KOLTER DR
INDIANA PA
15701-3522
US

IV. Provider business mailing address

645 KOLTER DR
INDIANA PA
15701-3522
US

V. Phone/Fax

Practice location:
  • Phone: 724-349-1111
  • Fax: 724-599-3666
Mailing address:
  • Phone: 724-349-1111
  • Fax: 724-599-3666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP024042L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: