Provider Demographics
NPI:1831412691
Name:ABDULALLY, MANDI JO (PHARMD)
Entity type:Individual
Prefix:
First Name:MANDI
Middle Name:JO
Last Name:ABDULALLY
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 1:1125 FREEPORT ROAD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238
Mailing Address - Country:US
Mailing Address - Phone:412-782-2277
Mailing Address - Fax:877-287-7226
Practice Address - Street 1:1125 FREEPORT ROAD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238
Practice Address - Country:US
Practice Address - Phone:412-782-2277
Practice Address - Fax:877-287-7226
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist