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General NPI Number Information
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NPI Number | 1023481488
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Entity Type | Individual
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Provider Name | CLARISSA ELIZABETH PENA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/07/2015
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 210 INDUSTRIAL PARK RD
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City | ELYSBURG
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State | PA
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Zip | 17824-9770
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Country | US
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Telephone | 844-878-5562
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Fax | 570-221-3711
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Provider Business Mailing Address
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Address Line | 210 INDUSTRIAL PARK RD
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City | ELYSBURG
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State | PA
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Zip | 17824-9770
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Country | US
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Telephone | 844-878-5562
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Fax | 570-221-3711
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP441297
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 441297
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 73659
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License Number State | CA
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