Provider Demographics
NPI:1003013202
Name:GORZELSKY, AMANDA ANN (PHARM D)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:ANN
Last Name:GORZELSKY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 MOUNT VIEW TER
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:PA
Mailing Address - Zip Code:15954-8430
Mailing Address - Country:US
Mailing Address - Phone:814-241-0071
Mailing Address - Fax:
Practice Address - Street 1:1086 FRANKLIN STREET
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15906
Practice Address - Country:US
Practice Address - Phone:814-534-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist