Healthcare Provider Details

I. General information

NPI: 1205133501
Provider Name (Legal Business Name): DEREK PAUL CAUSER PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MR. DEREK PAUL CAUSER

II. Dates (important events)

Enumeration Date: 02/22/2011
Last Update Date: 08/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 5TH AVE PAP 4205
PITTSBURGH PA
15222-3000
US

IV. Provider business mailing address

120 5TH AVE PAP 4205
PITTSBURGH PA
15222-3000
US

V. Phone/Fax

Practice location:
  • Phone: 814-443-6963
  • Fax: 814-445-4296
Mailing address:
  • Phone: 814-443-6963
  • Fax: 814-445-4296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12703
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP443996
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: