Provider Demographics
NPI:1942791413
Name:YANOSKI, HEIDI JOAN (PHARMD, MBA, RPH)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:JOAN
Last Name:YANOSKI
Suffix:
Gender:F
Credentials:PHARMD, MBA, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 DEWEY ST
Mailing Address - Street 2:
Mailing Address - City:DICKSON CITY
Mailing Address - State:PA
Mailing Address - Zip Code:18519-1703
Mailing Address - Country:US
Mailing Address - Phone:570-766-7615
Mailing Address - Fax:
Practice Address - Street 1:609 LUZERNE ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18504-2626
Practice Address - Country:US
Practice Address - Phone:570-344-4404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARPI012076183500000X
PARP452263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA183500000XMedicaid