Provider Demographics
NPI:1598039968
Name:SULLA, DARIA HELEN (PHARMD, MBA)
Entity Type:Individual
Prefix:MISS
First Name:DARIA
Middle Name:HELEN
Last Name:SULLA
Suffix:
Gender:F
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 SCRANTON CARBONDALE HWY
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-1127
Mailing Address - Country:US
Mailing Address - Phone:570-489-4274
Mailing Address - Fax:570-489-1834
Practice Address - Street 1:1011 SCRANTON CARBONDALE HWY
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-1127
Practice Address - Country:US
Practice Address - Phone:570-489-4274
Practice Address - Fax:570-489-1834
Is Sole Proprietor?:No
Enumeration Date:2012-03-02
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441030183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist