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General NPI Number Information
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NPI Number | 1043007610
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Entity Type | Individual
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Provider Name | MARVIN THOMAS PATHROSE PHARMD.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 3930 W CHESTER PIKE
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-3209
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Country | US
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Telephone | 610-353-2061
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Fax |
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Provider Business Mailing Address
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Address Line | 416 E LEAMY AVE
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City | SPRINGFIELD
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State | PA
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Zip | 19064-3020
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Country | US
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Telephone | 484-832-3572
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Fax |
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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 | RP451018
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License Number State | PA
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