Provider Demographics
NPI:1750516548
Name:STANCATI, DIANE E (RPH)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:E
Last Name:STANCATI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 S BYRNE RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-6213
Mailing Address - Country:US
Mailing Address - Phone:419-535-0069
Mailing Address - Fax:419-535-3212
Practice Address - Street 1:114 S BYRNE RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-6213
Practice Address - Country:US
Practice Address - Phone:419-535-0069
Practice Address - Fax:419-535-3212
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03110990183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist