Provider Demographics
NPI:1316751571
Name:POLIT-PANEK, SAMILYNN KRISTIN
Entity type:Individual
Prefix:
First Name:SAMILYNN
Middle Name:KRISTIN
Last Name:POLIT-PANEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 YORK AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18643-2435
Mailing Address - Country:US
Mailing Address - Phone:570-762-9132
Mailing Address - Fax:
Practice Address - Street 1:960 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:PA
Practice Address - Zip Code:18643-1199
Practice Address - Country:US
Practice Address - Phone:570-654-7422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038783L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist