Healthcare Provider Details

I. General information

NPI: 1700558640
Provider Name (Legal Business Name): JEFFREY CARL PUNTURERI RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9805 MCKNIGHT RD
PITTSBURGH PA
15237-6008
US

IV. Provider business mailing address

9805 MCKNIGHT RD
PITTSBURGH PA
15237-6008
US

V. Phone/Fax

Practice location:
  • Phone: 412-366-3214
  • Fax: 412-366-4107
Mailing address:
  • Phone: 412-366-3214
  • Fax: 412-366-4107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP042130R
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: