Provider Demographics
NPI:1467525733
Name:SZCZOTKA, ANDREW (PHARM D)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:SZCZOTKA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12112 TRAVERTINE CT
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-6128
Mailing Address - Country:US
Mailing Address - Phone:858-204-2441
Mailing Address - Fax:858-695-2344
Practice Address - Street 1:12112 TRAVERTINE CT
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-6128
Practice Address - Country:US
Practice Address - Phone:858-204-2441
Practice Address - Fax:858-695-2344
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH38019183500000X
NV8597183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist