Provider Demographics
NPI:1427281104
Name:MCCLUSKEY, PATTI LYNN (RPH)
Entity type:Individual
Prefix:MRS
First Name:PATTI
Middle Name:LYNN
Last Name:MCCLUSKEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3566 TRIPOLI BLVD
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-7880
Mailing Address - Country:US
Mailing Address - Phone:610-442-6388
Mailing Address - Fax:
Practice Address - Street 1:3566 TRIPOLI BLVD
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-7880
Practice Address - Country:US
Practice Address - Phone:610-442-6388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438850183500000X
NJ28RI02624400183500000X
FLPS51521183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist