Provider Demographics
NPI:1013152156
Name:MAREK, WENDY KRISTINA (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:WENDY
Middle Name:KRISTINA
Last Name:MAREK
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 1:1 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-6520
Mailing Address - Country:US
Mailing Address - Phone:570-454-2476
Mailing Address - Fax:
Practice Address - Street 1:1 E BROAD ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-6520
Practice Address - Country:US
Practice Address - Phone:570-454-2476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist