Provider Demographics
NPI:1588779128
Name:SKLEDAR, SUSAN JEAN (RPH)
Entity type:Individual
Prefix:PROF
First Name:SUSAN
Middle Name:JEAN
Last Name:SKLEDAR
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 1:712 ILLINI DR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1920
Mailing Address - Country:US
Mailing Address - Phone:724-325-3012
Mailing Address - Fax:412-647-1605
Practice Address - Street 1:200 LOTHROP ST
Practice Address - Street 2:302 SCAIFE HALL (UNIVERSITY OF PITTSBURGH MEDICAL CNTR)
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-647-6424
Practice Address - Fax:412-647-1605
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP-035949-L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist