MEDICARE: DIANE MARIE PASTOREK

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	RP031830L	PA

General Provider Information

NPI Number	:	1255646204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE MARIE PASTOREK

Provider Business Mailing Address
First Line	:	114 TANGLEWOOD DR
Second Line	:
City	:	VALENCIA
State	:	PA
Zip	:	16059-2552
Country	:	US
Telephone Number	:	724-898-2541
Fax Number	:

Provider Business Practice Location Address
First Line	:	4960 WILLIAM FLYNN HWY
Second Line	:	SUITE 10
City	:	ALLISON PARK
State	:	PA
Zip	:	15101-2354
Country	:	US
Telephone Number	:	724-443-5455
Fax Number	:

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

Provider Enumeration Date	:	08/15/2010
Last Update Date	:	08/15/2010

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Directions to “ DIANE MARIE PASTOREK ” Practice Location

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