Provider Demographics
NPI:1366721391
Name:SCIULLI, KATIE (PHARMD)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:SCIULLI
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 1:248 BENTBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-2254
Mailing Address - Country:US
Mailing Address - Phone:866-344-4874
Mailing Address - Fax:
Practice Address - Street 1:3000 ERICSSON DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WARRENDALE
Practice Address - State:PA
Practice Address - Zip Code:15086-6501
Practice Address - Country:US
Practice Address - Phone:866-344-4874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist