Provider Demographics
NPI:1154512176
Name:MINIELLY, MARIA J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:J
Last Name:MINIELLY
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 1:6520 STONEGATE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9297
Mailing Address - Country:US
Mailing Address - Phone:610-794-5380
Mailing Address - Fax:610-794-5415
Practice Address - Street 1:6520 STONEGATE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9297
Practice Address - Country:US
Practice Address - Phone:610-794-5380
Practice Address - Fax:610-794-5415
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP046272183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist