Provider Demographics
NPI:1770865149
Name:WARYWODA, ARLENE MICHELLE
Entity Type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:MICHELLE
Last Name:WARYWODA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CAVASINA DR
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-1767
Mailing Address - Country:US
Mailing Address - Phone:724-873-8790
Mailing Address - Fax:724-873-8796
Practice Address - Street 1:100 CAVASINA DR
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1767
Practice Address - Country:US
Practice Address - Phone:724-873-8790
Practice Address - Fax:724-873-8796
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443429183500000X
NC18652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist