Healthcare Provider Details

I. General information

NPI: 1144452657
Provider Name (Legal Business Name): MELINDA ELISE KOZMINSKI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2009
Last Update Date: 08/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 MOUNT ROYAL BLVD
PITTSBURGH PA
15223-1060
US

IV. Provider business mailing address

736 SALK HL 3501 TERRACE STREET
PITTSBURGH PA
15261-0001
US

V. Phone/Fax

Practice location:
  • Phone: 412-487-2173
  • Fax: 412-487-6091
Mailing address:
  • Phone: 412-383-7267
  • Fax: 412-624-8175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP443600
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: