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General NPI Number Information
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NPI Number | 1376866814
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Entity Type | Individual
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Provider Name | MRS. KIMBERLY ANN PADEZANIN
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Gender | Female
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Dates
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Enumeration Date | 03/11/2010
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Last Update Date | 03/11/2010
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Provider Practice Location Address
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Address Line | 2000 MARKET PLACE BLVD
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City | MOON TOWNSHIP
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State | PA
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Zip | 15108-9737
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Country | US
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Telephone | 412-859-0136
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Fax |
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Provider Business Mailing Address
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Address Line | 214 HERBST ROAD
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City | CORAOPOLIS
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State | PA
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Zip | 15108
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Country | US
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Telephone | 412-861-7039
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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 | RP038171L
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License Number State | PA
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