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NPI Code Detail

MEDICARE: NICOLE MANNELLA HASSON PHARMD

MEDICARE: NICOLE MANNELLA HASSON PHARMD
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
1183500000XPharmacistRP444577PA
2174H00000XHealth EducatorPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225523152
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE MANNELLA HASSON PHARMD
Provider Business Mailing Address
First Line : 512 CLEARVIEW DR
Second Line :
City : HOLLIDAYSBURG
State : PA
Zip : 16648-9279
Country : US
Telephone Number : 724-600-9481
Fax Number :
Provider Business Practice Location Address
First Line : 4200 INDUSTRIAL PARK DR
Second Line :
City : ALTOONA
State : PA
Zip : 16602-1737
Country : US
Telephone Number : 814-283-1821
Fax Number : 814-283-2216
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2018
Last Update Date : 01/12/2026

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