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General NPI Number Information
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NPI Number | 1669745378
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Entity Type | Individual
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Provider Name | JONATHAN GIBNEY PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2012
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 18993 MUNCHY BRANCH RD
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City | REHOBOTH BEACH
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State | DE
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Zip | 19971-8762
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Country | US
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Telephone | 302-226-0220
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Fax |
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Provider Business Mailing Address
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Address Line | 5701 CENTRE AVE APT 1503
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City | PITTSBURGH
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State | PA
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Zip | 15206-3749
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Country | US
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Telephone |
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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 | A1-0003728
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License Number State | DE
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