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General NPI Number Information
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NPI Number | 1902920168
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Entity Type | Individual
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Provider Name | VINCENT MICHAEL CANZANESE RPH
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Gender | Male
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 334 BALTIMORE PIKE
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City | SPRINGFIELD
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State | PA
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Zip | 19064-3631
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Country | US
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Telephone | 610-543-1765
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Fax | 610-690-2689
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Provider Business Mailing Address
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Address Line | 572 S HEILBRON DR
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City | MEDIA
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State | PA
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Zip | 19063-4500
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Country | US
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Telephone | 610-891-6796
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Fax | 610-690-2689
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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 | RPO4O150L
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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 | A1-0003363
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License Number State | DE
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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 | 28R102884300
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License Number State | NJ
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