MEDICARE: SUZANNE YANUSKI MS, RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP036195L	PA

General Provider Information

NPI Number	:	1053913434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE YANUSKI MS, RPH

Provider Business Mailing Address
First Line	:	2408 PEROT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-2528
Country	:	US
Telephone Number	:	215-873-1532
Fax Number	:

Provider Business Practice Location Address
First Line	:	3605 EDGMONT AVE
Second Line	:
City	:	BROOKHAVEN
State	:	PA
Zip	:	19015-2862
Country	:	US
Telephone Number	:	610-499-9112
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2020
Last Update Date	:	11/11/2020

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