Provider Demographics
NPI:1063589380
Name:LENCZYNSKI, MICHAEL EDWARD (RPH)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:EDWARD
Last Name:LENCZYNSKI
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 1:734 QUINCE LN
Mailing Address - Street 2:
Mailing Address - City:SECANE
Mailing Address - State:PA
Mailing Address - Zip Code:19018-4516
Mailing Address - Country:US
Mailing Address - Phone:610-328-6726
Mailing Address - Fax:800-283-7364
Practice Address - Street 1:780 PRIMOS AVE
Practice Address - Street 2:SUITE D
Practice Address - City:FOLCROFT
Practice Address - State:PA
Practice Address - Zip Code:19032-2000
Practice Address - Country:US
Practice Address - Phone:610-583-7950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030702L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist