Provider Demographics
NPI:1467109959
Name:LEGNOSKY, JILLIAN (CPHT)
Entity Type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:
Last Name:LEGNOSKY
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 S MARKET ST
Mailing Address - Street 2:
Mailing Address - City:NEW WILMINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16142-1201
Mailing Address - Country:US
Mailing Address - Phone:724-946-3531
Mailing Address - Fax:
Practice Address - Street 1:135 S MARKET ST
Practice Address - Street 2:
Practice Address - City:NEW WILMINGTON
Practice Address - State:PA
Practice Address - Zip Code:16142-1201
Practice Address - Country:US
Practice Address - Phone:724-946-3531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA30056847183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1379871OtherNABP