Provider Demographics
NPI:1427145150
Name:LIVINGSTON, MATTHEW S (PHARMD RPL)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:S
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:PHARMD RPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:CLAIRTON
Mailing Address - State:PA
Mailing Address - Zip Code:15025-1744
Mailing Address - Country:US
Mailing Address - Phone:412-233-7100
Mailing Address - Fax:412-233-3032
Practice Address - Street 1:550 MILLER AVE
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-1744
Practice Address - Country:US
Practice Address - Phone:412-233-7100
Practice Address - Fax:412-233-3032
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437850183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP437850OtherSTATE LICENSE