Provider Demographics
NPI:1285031724
Name:DESIGNOR, REBECCA JEAN (PHARM D)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:JEAN
Last Name:DESIGNOR
Suffix:
Gender:F
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 1:280 MEYER RD
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-9438
Mailing Address - Country:US
Mailing Address - Phone:610-905-8110
Mailing Address - Fax:
Practice Address - Street 1:3601 MIDVALE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19129-1712
Practice Address - Country:US
Practice Address - Phone:215-842-2950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-27
Last Update Date:2014-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP449295183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist