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General NPI Number Information
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NPI Number | 1629494844
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Entity Type | Individual
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Provider Name | MARK DAVID YAGODZINSKI PHARM D
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Gender | Male
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Dates
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Enumeration Date | 03/12/2014
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Last Update Date | 03/12/2014
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Provider Practice Location Address
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Address Line | 1 UNIVERSITY DRIVE C
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City | PITTSBURGH
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State | PA
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Zip | 15240-1000
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Country | US
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Telephone | 412-360-6220
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Fax |
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Provider Business Mailing Address
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Address Line | 1413 MOUNT VERNON RD
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City | CHARLESTON
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State | WV
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Zip | 25314-2531
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Country | US
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Telephone | 859-240-2635
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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 | PS 50281
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License Number State | FL
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