Provider Demographics
NPI:1366016099
Name:BIELTZ, MAUREEN MICHELLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:MICHELLE
Last Name:BIELTZ
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 1:581 TALON WAY
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-9806
Mailing Address - Country:US
Mailing Address - Phone:412-327-5516
Mailing Address - Fax:
Practice Address - Street 1:2 GANSEVOORT ST LBBY 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-1667
Practice Address - Country:US
Practice Address - Phone:406-219-1438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444777183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist