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NPI Code Detail

MEDICARE: MRS. KIMBERLY ANN PADEZANIN

MEDICARE:  MRS. KIMBERLY ANN PADEZANIN
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
1183500000XPharmacistRP038171LPA

General Provider Information

NPI Number : 1376866814
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY ANN PADEZANIN
Provider Business Mailing Address
First Line : 214 HERBST ROAD
Second Line :
City : CORAOPOLIS
State : PA
Zip : 15108
Country : US
Telephone Number : 412-861-7039
Fax Number :
Provider Business Practice Location Address
First Line : 2000 MARKET PLACE BLVD
Second Line :
City : MOON TOWNSHIP
State : PA
Zip : 15108-9737
Country : US
Telephone Number : 412-859-0136
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2010
Last Update Date : 03/11/2010

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Directions to “ MRS. KIMBERLY ANN PADEZANIN ” Practice Location

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