Provider Demographics
NPI:1801175005
Name:BARLETTA, MATTHEW D (PHARMD)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:D
Last Name:BARLETTA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 ERICSSON DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WARRENDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15086-6501
Mailing Address - Country:US
Mailing Address - Phone:724-778-6000
Mailing Address - Fax:
Practice Address - Street 1:3000 ERICSSON DR STE 100
Practice Address - Street 2:
Practice Address - City:WARRENDALE
Practice Address - State:PA
Practice Address - Zip Code:15086-6501
Practice Address - Country:US
Practice Address - Phone:724-778-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445122183500000X
MD19763183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist