Provider Demographics
NPI:1326532458
Name:STASKYWICZ, LYNDSEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:
Last Name:STASKYWICZ
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 1:117 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4087
Mailing Address - Country:US
Mailing Address - Phone:701-223-0936
Mailing Address - Fax:
Practice Address - Street 1:211 W BURLEIGH AVE APT 308
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-9042
Practice Address - Country:US
Practice Address - Phone:218-269-1243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH6038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist