Provider Demographics
NPI:1265621155
Name:SCANDROL, NICOLE MARIA (PHARMD)
Entity type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:MARIA
Last Name:SCANDROL
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 1:725 PLEASANT HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:LEECHBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15656-8392
Mailing Address - Country:US
Mailing Address - Phone:724-339-4943
Mailing Address - Fax:
Practice Address - Street 1:200 TARENTUM BRIDGE RD
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068
Practice Address - Country:US
Practice Address - Phone:724-339-4943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440127183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist