Provider Demographics
NPI:1871265389
Name:NOTARIANNI, TRACY (RPH)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:NOTARIANNI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 LOVI RD
Mailing Address - Street 2:
Mailing Address - City:FREEDOM
Mailing Address - State:PA
Mailing Address - Zip Code:15042
Mailing Address - Country:US
Mailing Address - Phone:412-203-1444
Mailing Address - Fax:
Practice Address - Street 1:2500 LOVI RD
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:PA
Practice Address - Zip Code:15042
Practice Address - Country:US
Practice Address - Phone:412-203-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-03
Last Update Date:2021-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038331L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist