Provider Demographics
NPI:1023479904
Name:BETZALA, CHRISTINE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:BETZALA
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 1:101 BYERS DR
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-3319
Mailing Address - Country:US
Mailing Address - Phone:610-361-9523
Mailing Address - Fax:
Practice Address - Street 1:101 BYERS DR
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-3319
Practice Address - Country:US
Practice Address - Phone:610-361-9523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437838183500000X
PARPI000175183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist