Healthcare Provider Details

I. General information

NPI: 1174431993
Provider Name (Legal Business Name): AMANDA ROSE PROSENJAK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 ALLEGHENY CTR
PITTSBURGH PA
15212-5402
US

IV. Provider business mailing address

2 ALLEGHENY CTR
PITTSBURGH PA
15212-5402
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-8890
  • Fax:
Mailing address:
  • Phone: 412-359-8890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRP443922
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: