Provider Demographics
NPI:1053861732
Name:NICOLA, ALLYSON (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:NICOLA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:847 MIDLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:PA
Mailing Address - Zip Code:15059-1511
Mailing Address - Country:US
Mailing Address - Phone:724-643-6520
Mailing Address - Fax:
Practice Address - Street 1:847 MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:PA
Practice Address - Zip Code:15059-1511
Practice Address - Country:US
Practice Address - Phone:724-643-6520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP451035183500000X
PARPI010946183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist