Provider Demographics
NPI:1215259940
Name:CASCIATO, JENNIFER L (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:CASCIATO
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 1:111 WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:VENETIA
Mailing Address - State:PA
Mailing Address - Zip Code:15367-1447
Mailing Address - Country:US
Mailing Address - Phone:724-942-4756
Mailing Address - Fax:
Practice Address - Street 1:99 MATTHEW DR
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8950
Practice Address - Country:US
Practice Address - Phone:724-430-0174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP046215L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP046215LOtherLICENSE NUMBER