Provider Demographics
NPI:1558543645
Name:CERVONE, ADRIENNE BRENNA
Entity Type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:BRENNA
Last Name:CERVONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2115
Mailing Address - Country:US
Mailing Address - Phone:724-774-0919
Mailing Address - Fax:724-774-5070
Practice Address - Street 1:601 3RD ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2115
Practice Address - Country:US
Practice Address - Phone:724-774-0919
Practice Address - Fax:724-774-5070
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441599183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist