Provider Demographics
NPI:1003137779
Name:BUDASH, DEAN STANLEY
Entity Type:Individual
Prefix:MR
First Name:DEAN
Middle Name:STANLEY
Last Name:BUDASH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 E PIKE ST
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-1311
Mailing Address - Country:US
Mailing Address - Phone:724-745-4418
Mailing Address - Fax:724-745-2710
Practice Address - Street 1:25 E PIKE ST
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1311
Practice Address - Country:US
Practice Address - Phone:724-745-4418
Practice Address - Fax:724-745-2710
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP-030528-L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP-030528-LOtherPHARMACIST LICENSE