Provider Demographics
NPI:1285746644
Name:CELLA, STACY LYNN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STACY LYNN
Middle Name:
Last Name:CELLA
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 1:663 ORANGE RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-6111
Mailing Address - Country:US
Mailing Address - Phone:570-333-5385
Mailing Address - Fax:
Practice Address - Street 1:3382 BIRNEY PLZ
Practice Address - Street 2:
Practice Address - City:MOOSIC
Practice Address - State:PA
Practice Address - Zip Code:18507-1560
Practice Address - Country:US
Practice Address - Phone:570-341-0915
Practice Address - Fax:847-396-2578
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440227183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARPI000104OtherINJECTABLE ADMINISTRATION LICENSE
PARP440227OtherSTATE LICENSE #