Provider Demographics
NPI:1821725193
Name:PANEK, ALEXANDRA MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:MARIE
Last Name:PANEK
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 1:742 BLOOM RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-1367
Mailing Address - Country:US
Mailing Address - Phone:607-972-5495
Mailing Address - Fax:
Practice Address - Street 1:210 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:ELYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17824-9770
Practice Address - Country:US
Practice Address - Phone:844-878-5562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP455899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist