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General NPI Number Information
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NPI Number | 1629887120
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Entity Type | Individual
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Provider Name | CHRISTINA DEREDZA-MASUKU
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Gender | Female
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 130 SCHUYLKILL RD
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-2232
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Country | US
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Telephone | 610-933-7487
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Fax |
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Provider Business Mailing Address
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Address Line | 512 SPRING MANOR BLVD
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City | GILBERTSVILLE
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State | PA
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Zip | 19525-8002
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Country | US
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Telephone | 215-237-7015
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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 | RP459111
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP459111
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License Number State | PR
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