Provider Demographics
NPI:1083901615
Name:MEDLEY, KAREM SUZANNE
Entity Type:Individual
Prefix:
First Name:KAREM
Middle Name:SUZANNE
Last Name:MEDLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 GRANDVIEW CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-7100
Mailing Address - Country:US
Mailing Address - Phone:724-799-2238
Mailing Address - Fax:724-799-2238
Practice Address - Street 1:550 GRANDVIEW CROSSING DR
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-7100
Practice Address - Country:US
Practice Address - Phone:724-799-2238
Practice Address - Fax:724-799-2238
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-04
Last Update Date:2011-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP039975L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist