Provider Demographics
NPI:1639483613
Name:PETTIA, ASHLEY CETOLA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:CETOLA
Last Name:PETTIA
Suffix:
Gender:F
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 1:200 MILL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OAKS
Mailing Address - State:PA
Mailing Address - Zip Code:19456
Mailing Address - Country:US
Mailing Address - Phone:610-650-3927
Mailing Address - Fax:610-783-3203
Practice Address - Street 1:200 MILL ROAD
Practice Address - Street 2:
Practice Address - City:OAKS
Practice Address - State:PA
Practice Address - Zip Code:19456-0985
Practice Address - Country:US
Practice Address - Phone:610-650-3927
Practice Address - Fax:610-783-3203
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist