Provider Demographics
NPI:1538823729
Name:MARKS, DEBRA
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:MARKS
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 1:641 GREER ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2819
Mailing Address - Country:US
Mailing Address - Phone:412-999-3249
Mailing Address - Fax:
Practice Address - Street 1:420 E WATERFRONT DR
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120-1143
Practice Address - Country:US
Practice Address - Phone:412-462-5359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031864L1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty