Provider Demographics
NPI:1750659553
Name:GILL, SANDRA L (SANDRA GILL)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:L
Last Name:GILL
Suffix:
Gender:F
Credentials:SANDRA GILL
Other - Prefix:DR
Other - First Name:SANDRA
Other - Middle Name:L
Other - Last Name:KANE-GILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SANDRA GILL
Mailing Address - Street 1:918 SALK HALL
Mailing Address - Street 2:3501 TERRACE ST
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15261-1909
Mailing Address - Country:US
Mailing Address - Phone:412-624-5150
Mailing Address - Fax:412-624-1850
Practice Address - Street 1:918 SALK HALL
Practice Address - Street 2:3501 TERRACE ST
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261-1909
Practice Address - Country:US
Practice Address - Phone:412-624-5150
Practice Address - Fax:412-624-1850
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4383921835P0018X
MI53020297301835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist