Provider Demographics
NPI:1407427065
Name:CROSSEY, CAROLINE DANIELS (PHARMD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:DANIELS
Last Name:CROSSEY
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 1:474 SHELBOURNE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239-3614
Mailing Address - Country:US
Mailing Address - Phone:412-926-5080
Mailing Address - Fax:
Practice Address - Street 1:5215 CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1303
Practice Address - Country:US
Practice Address - Phone:412-926-5080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020025138183500000X
PARP455503183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist