Provider Demographics
NPI:1104964923
Name:DUCKO, MARK ANDREW (RPH)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:ANDREW
Last Name:DUCKO
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 1:230 OAK ENTRANCE DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3024
Mailing Address - Country:US
Mailing Address - Phone:412-650-2081
Mailing Address - Fax:
Practice Address - Street 1:5001 LIBRARY RD
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-2811
Practice Address - Country:US
Practice Address - Phone:412-831-0440
Practice Address - Fax:413-831-8815
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP-032292L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist