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General NPI Number Information
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NPI Number | 1083580195
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Entity Type | Individual
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Provider Name | MALLORIE MAE DUKMEN
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Gender | Female
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Dates
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Enumeration Date | 10/15/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 173 HOLLY RD
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City | GILBERTSVILLE
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State | PA
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Zip | 19525-9367
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Country | US
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Telephone | 610-473-3204
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Fax |
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Provider Business Mailing Address
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Address Line | 7 W PENN ST
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City | SCHUYLKILL HAVEN
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State | PA
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Zip | 17972-1944
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Country | US
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Telephone | 570-573-9051
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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 | RP459827
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License Number State | PA
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