Provider Demographics
NPI:1205566452
Name:GLADYSZ, LINDSAY PRESTON (PHARMD)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:PRESTON
Last Name:GLADYSZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:HARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:595 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2597
Mailing Address - Country:US
Mailing Address - Phone:412-736-3258
Mailing Address - Fax:
Practice Address - Street 1:595 W STATE ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2597
Practice Address - Country:US
Practice Address - Phone:215-245-2228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-11
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP448068333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP448068OtherPHARMACIST LICENSE