Provider Demographics
NPI:1679893481
Name:DEGNAN, THERESE ANN (RPH)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:ANN
Last Name:DEGNAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 PARTRIDGE RUN RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-2824
Mailing Address - Country:US
Mailing Address - Phone:412-854-1305
Mailing Address - Fax:
Practice Address - Street 1:2100 WASHINGTON PIKE
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106
Practice Address - Country:US
Practice Address - Phone:412-276-7077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034304L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist