=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467277939
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITANY VERIKAS LPN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/20/2024
-----------------------------------------------------
Last Update Date | 11/20/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 301 SMITH DR STE 3
-----------------------------------------------------
City | CRANBERRY TOWNSHIP
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16066-4131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-779-2010
-----------------------------------------------------
Fax | 724-779-2011
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 301 SMITH DR STE 3
-----------------------------------------------------
City | CRANBERRY TOWNSHIP
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16066-4131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-779-2010
-----------------------------------------------------
Fax | 724-779-2011
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QA0401X
-----------------------------------------------------
Taxonomy Name | Addiction Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number | PN291267
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------