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General NPI Number Information
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NPI Number | 1851345094
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Entity Type | Individual
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Provider Name | NICHOLAS ANTHONY DWORNITSKI RPH
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Gender | Male
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 222 N 9TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-1822
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Country | US
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Telephone | 215-627-4567
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Fax | 215-627-4667
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Provider Business Mailing Address
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Address Line | 4225 BENSALEM BLVD
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City | BENSALEM
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State | PA
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Zip | 19020-4917
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Country | US
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Telephone | 215-638-2852
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Fax | 215-638-2852
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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 | RP027892L
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License Number State | PA
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