Healthcare Provider Details

I. General information

NPI: 1699320101
Provider Name (Legal Business Name): TRINA KUTCH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRINA CORNMAN PHARMD

II. Dates (important events)

Enumeration Date: 08/02/2019
Last Update Date: 08/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 GAMMA DR
PITTSBURGH PA
15238-2963
US

IV. Provider business mailing address

119 MONTEREED ST
KITTANNING PA
16201-1923
US

V. Phone/Fax

Practice location:
  • Phone: 419-449-0680
  • Fax:
Mailing address:
  • Phone: 724-859-9010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP44837
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP448837
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: