Provider Demographics
NPI:1639552557
Name:D'AMATO, MEGAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:D'AMATO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:FURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 LAUREL MALL
Mailing Address - Street 2:ROUTE 93
Mailing Address - City:HAZLE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18202-1201
Mailing Address - Country:US
Mailing Address - Phone:570-455-5401
Mailing Address - Fax:847-396-3178
Practice Address - Street 1:5 LAUREL MALL
Practice Address - Street 2:ROUTE 93
Practice Address - City:HAZLE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18202-1201
Practice Address - Country:US
Practice Address - Phone:570-455-5401
Practice Address - Fax:847-396-3178
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449676183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP449676OtherPHARMACIST LICENSE