Provider Demographics
NPI:1740010925
Name:DUDECK, GILLIAN (PHARMD)
Entity type:Individual
Prefix:
First Name:GILLIAN
Middle Name:
Last Name:DUDECK
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 1:320 E NORTH AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4772
Mailing Address - Country:US
Mailing Address - Phone:412-359-8677
Mailing Address - Fax:
Practice Address - Street 1:320 E NORTH AVE STE 111
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4772
Practice Address - Country:US
Practice Address - Phone:412-359-8677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP458652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist