Provider Demographics
NPI:1417181991
Name:FOROSTY, ZENON OSTAP (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:ZENON
Middle Name:OSTAP
Last Name:FOROSTY
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 W LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-1770
Mailing Address - Country:US
Mailing Address - Phone:330-534-1907
Mailing Address - Fax:
Practice Address - Street 1:147 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-1770
Practice Address - Country:US
Practice Address - Phone:330-534-1907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032113911835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist