Provider Demographics
NPI:1215278296
Name:PANICOLA, ALISON (PHARMD)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:PANICOLA
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 1:236 E GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-1080
Mailing Address - Country:US
Mailing Address - Phone:302-653-3610
Mailing Address - Fax:302-653-3614
Practice Address - Street 1:236 E GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-1080
Practice Address - Country:US
Practice Address - Phone:302-653-3610
Practice Address - Fax:302-653-3614
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist