Provider Demographics
NPI:1154054625
Name:PALENGAS, CHRISTINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:PALENGAS
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 1:41 MEDIA LINE RD APT C3
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-1246
Mailing Address - Country:US
Mailing Address - Phone:610-739-3117
Mailing Address - Fax:
Practice Address - Street 1:2941 N 5TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-2802
Practice Address - Country:US
Practice Address - Phone:215-278-2797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-02
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP452385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist