1538491659 NPI number — MISS JESSICA MARRAWAY FINCKE PHARMD

Table of content: MISS JESSICA MARRAWAY FINCKE PHARMD (NPI 1538491659)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538491659 NPI number — MISS JESSICA MARRAWAY FINCKE PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINCKE
Provider First Name:
JESSICA
Provider Middle Name:
MARRAWAY
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BOYD
Provider Other First Name:
JESSICA
Provider Other Middle Name:
MARRAWAY
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1538491659
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 LONG DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15241-2006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-979-9995
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3000 ERICSSON DR STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARRENDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15086-6501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-772-6000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/01/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RP442948 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)