Provider Demographics
NPI:1790380715
Name:GHERARDI, JANICE MARIE
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:MARIE
Last Name:GHERARDI
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 1:134 YOUNGSTOWN HUBBARD RD
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-1930
Mailing Address - Country:US
Mailing Address - Phone:330-534-3141
Mailing Address - Fax:330-534-9425
Practice Address - Street 1:134 YOUNGSTOWN HUBBARD RD
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-1930
Practice Address - Country:US
Practice Address - Phone:330-534-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03120807183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist