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NPI Code Detail

MEDICARE: IAN KISH

MEDICARE: IAN KISH
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
1183500000XPharmacistRP449064PA

General Provider Information

NPI Number : 1912306119
Entity Type Code : Individual
Provider Name (Legal Business Name) : IAN KISH
Provider Business Mailing Address
First Line : 133 S 18TH ST
Second Line : APT # 1
City : PITTSBURGH
State : PA
Zip : 15203-1867
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1915 E CARSON ST
Second Line :
City : PITTSBURGH
State : PA
Zip : 15203-1835
Country : US
Telephone Number : 412-381-1464
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2014
Last Update Date : 08/14/2014

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Directions to “ IAN KISH ” Practice Location

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