Provider Demographics
NPI:1679051098
Name:AZIZ, KEROLOS (PHARM D)
Entity Type:Individual
Prefix:
First Name:KEROLOS
Middle Name:
Last Name:AZIZ
Suffix:
Gender:M
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 1:936 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BADEN
Mailing Address - State:PA
Mailing Address - Zip Code:15005-1411
Mailing Address - Country:US
Mailing Address - Phone:724-766-5162
Mailing Address - Fax:
Practice Address - Street 1:20260 ROUTE 19
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-6113
Practice Address - Country:US
Practice Address - Phone:724-742-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP452271183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist