Provider Demographics
NPI:1356752117
Name:URBAN, TRACI (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:TRACI
Middle Name:
Last Name:URBAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TRACI
Other - Middle Name:
Other - Last Name:ONDIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2661 FREEPORT RD
Mailing Address - Street 2:2385
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-1411
Mailing Address - Country:US
Mailing Address - Phone:412-820-6781
Mailing Address - Fax:
Practice Address - Street 1:2661 FREEPORT RD
Practice Address - Street 2:2385
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-1411
Practice Address - Country:US
Practice Address - Phone:412-820-6781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP448473183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist