Provider Demographics
NPI:1922770866
Name:PUKANSKY, LAUREN (RPH)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:PUKANSKY
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 1:3701 STATE ROUTE 88
Mailing Address - Street 2:
Mailing Address - City:FINLEYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15332-1319
Mailing Address - Country:US
Mailing Address - Phone:724-348-6229
Mailing Address - Fax:
Practice Address - Street 1:3701 STATE ROUTE 88
Practice Address - Street 2:
Practice Address - City:FINLEYVILLE
Practice Address - State:PA
Practice Address - Zip Code:15332-1319
Practice Address - Country:US
Practice Address - Phone:724-348-6229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040927L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist