Provider Demographics
NPI:1336805597
Name:SULLIVAN, CASSANDRA (PHARM D)
Entity type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:WISYANSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4931 PLUM WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201
Mailing Address - Country:US
Mailing Address - Phone:724-289-6657
Mailing Address - Fax:
Practice Address - Street 1:4111 WILLIAM PN HWY
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146
Practice Address - Country:US
Practice Address - Phone:412-372-5288
Practice Address - Fax:412-374-9089
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-11
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
183700000X
PARP459098183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No183700000XPharmacy Service ProvidersPharmacy Technician