Provider Demographics
NPI:1215210604
Name:KNASIAK, ANDREW GERARD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:GERARD
Last Name:KNASIAK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CHATHAM RD
Mailing Address - Street 2:
Mailing Address - City:GIBBSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08026-1405
Mailing Address - Country:US
Mailing Address - Phone:856-727-1299
Mailing Address - Fax:
Practice Address - Street 1:3046 ROUTE 38
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-9723
Practice Address - Country:US
Practice Address - Phone:856-727-1299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03378300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist