MEDICARE: PHILLIP J SULKIN 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	RP034291L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RP034291L	OTHER	PA	RPH LICENCE

General Provider Information

NPI Number	:	1093168155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILLIP J SULKIN RPH

Provider Business Mailing Address
First Line	:	1236 WINDERMERE DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15218-1146
Country	:	US
Telephone Number	:	412-855-7562
Fax Number	:

Provider Business Practice Location Address
First Line	:	1236 WINDERMERE DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15218-1146
Country	:	US
Telephone Number	:	412-855-7562
Fax Number	:

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

Provider Enumeration Date	:	07/13/2016
Last Update Date	:	07/13/2016

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