Provider Demographics
NPI:1124749239
Name:TUCKER, MAEVE CATHERINE
Entity type:Individual
Prefix:
First Name:MAEVE
Middle Name:CATHERINE
Last Name:TUCKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 TUNNEL BLVD APT 327
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-6109
Mailing Address - Country:US
Mailing Address - Phone:610-757-8540
Mailing Address - Fax:
Practice Address - Street 1:201 GRACE STREET
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15211
Practice Address - Country:US
Practice Address - Phone:412-381-1464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP457109183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist