Provider Demographics
NPI:1992110407
Name:SCARAMASTRO, THERESA (PHARMD)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:SCARAMASTRO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 HOYT ST
Mailing Address - Street 2:
Mailing Address - City:PRINGLE
Mailing Address - State:PA
Mailing Address - Zip Code:18704-1848
Mailing Address - Country:US
Mailing Address - Phone:570-878-9734
Mailing Address - Fax:
Practice Address - Street 1:393 HOYT ST
Practice Address - Street 2:
Practice Address - City:PRINGLE
Practice Address - State:PA
Practice Address - Zip Code:18704-1848
Practice Address - Country:US
Practice Address - Phone:570-878-9734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP448683183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist