Provider Demographics
NPI:1710269717
Name:BAPTISTE, TINA DICUCCIO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:DICUCCIO
Last Name:BAPTISTE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PINE CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090
Mailing Address - Country:US
Mailing Address - Phone:412-366-2456
Mailing Address - Fax:
Practice Address - Street 1:30 PINE CREEK ROAD
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090
Practice Address - Country:US
Practice Address - Phone:412-366-2456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442107183500000X
OHRPH03329073183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist