Provider Demographics
NPI:1508180555
Name:GESK, DIANE MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:MARIE
Last Name:GESK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 CROSSCREEK DR
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-5659
Mailing Address - Country:US
Mailing Address - Phone:724-438-5906
Mailing Address - Fax:
Practice Address - Street 1:99 MATTHEW DR
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8950
Practice Address - Country:US
Practice Address - Phone:724-430-0174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP041883L183500000X
WVRP0005803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist