Provider Demographics
NPI:1932495397
Name:SLEZAK, ALLISON N (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:N
Last Name:SLEZAK
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 1:5063 N ABERDEEN PL
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-5603
Mailing Address - Country:US
Mailing Address - Phone:724-840-8368
Mailing Address - Fax:
Practice Address - Street 1:5063 N ABERDEEN PL
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-5603
Practice Address - Country:US
Practice Address - Phone:724-840-8368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202208390183500000X
PARP443908183500000X
IDP8344183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist