Provider Demographics
NPI:1104142157
Name:AKANOWICZ, JONATHAN ROBERT (PHARM D)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:ROBERT
Last Name:AKANOWICZ
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4924 APPLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-1168
Mailing Address - Country:US
Mailing Address - Phone:412-916-7782
Mailing Address - Fax:
Practice Address - Street 1:1125 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3103
Practice Address - Country:US
Practice Address - Phone:412-782-2277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist