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General NPI Number Information
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NPI Number | 1861805129
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Entity Type | Individual
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Provider Name | LISA MINECCI KUTNEY PHARM.D., R.PH.
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Gender | Male
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 12311 ACADEMY RD
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City | PHILADELPHIA
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State | PA
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Zip | 19154-1927
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Country | US
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Telephone | 215-637-4690
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Fax | 215-637-6121
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Provider Business Mailing Address
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Address Line | 12311 ACADEMY RD
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City | PHILADELPHIA
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State | PA
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Zip | 19154-1927
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Country | US
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Telephone | 215-637-4690
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Fax | 215-637-6121
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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 | RP445354
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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 | RPI006334
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI02452800
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH8266
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License Number State | SC
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