Provider Demographics
NPI:1093026353
Name:HAZEL, DONNA JEAN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:HAZEL
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 ALPHA DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2819
Mailing Address - Country:US
Mailing Address - Phone:412-967-8507
Mailing Address - Fax:412-967-8657
Practice Address - Street 1:639 ALPHA DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2819
Practice Address - Country:US
Practice Address - Phone:412-967-8507
Practice Address - Fax:412-967-8657
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030643L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist