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General NPI Number Information
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NPI Number | 1134659998
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Entity Type | Individual
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Provider Name | KASEY ANN MARTIK
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Gender | Female
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 06/14/2017
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Provider Practice Location Address
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Address Line | 300 MARKET STREET
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City | ELIZABETH
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State | PA
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Zip | 15037
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Country | US
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Telephone | 412-384-2890
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Fax |
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Provider Business Mailing Address
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Address Line | 134 MOUNT VERNON DR
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City | MCKEESPORT
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State | PA
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Zip | 15135-3000
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Country | US
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Telephone | 412-523-8887
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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 | RP451420
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License Number State | PA
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