Provider Demographics
NPI:1952611063
Name:PASQUARELLI, VINCENT A (RPH)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:A
Last Name:PASQUARELLI
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 1:880 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15223-1319
Mailing Address - Country:US
Mailing Address - Phone:412-782-2466
Mailing Address - Fax:412-782-4545
Practice Address - Street 1:880 BUTLER ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15223-1319
Practice Address - Country:US
Practice Address - Phone:412-782-2466
Practice Address - Fax:412-782-4545
Is Sole Proprietor?:No
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP041297T183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARPI003434OtherIMMUNIZATION CERTIFICATION NUMBER