Provider Demographics
NPI:1770730376
Name:CRESSLER, CLYDE L (RPH)
Entity type:Individual
Prefix:
First Name:CLYDE
Middle Name:L
Last Name:CRESSLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4040 CAISSONS CT
Mailing Address - Street 2:
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17025-1489
Mailing Address - Country:US
Mailing Address - Phone:717-823-8171
Mailing Address - Fax:
Practice Address - Street 1:1800 LINGLESTOWN RD
Practice Address - Street 2:103
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-3347
Practice Address - Country:US
Practice Address - Phone:717-232-9490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP026562L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist