Mary F Canzanese, RPH

Primary specialty

Nutrition Support PharmacistTaxonomy code 1835N1003X

License

RP-039513L Issued in PA

Practice address

107 Rutgers Ave Ste 1
Swarthmore, PA 19081-1725

Phone

(484) 472-6561

Fax

(484) 472-6562

NPI assigned

Jun 18, 2012

Last updated

Jun 18, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Mary Fitzgerald Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Trisons Pharmacy LLC

  dba Trisons Pharmacy & Compound Center

  • Compounding Pharmacy
  • Swarthmore, PA
  • NPI 1487915856
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1114280039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "572 S HEILBRON DR",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190634500",
            "telephone_number": "610-891-6796",
            "fax_number": "484-472-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 RUTGERS AVE STE 1",
            "city": "SWARTHMORE",
            "state": "PA",
            "postal_code": "190811725",
            "telephone_number": "484-472-6561",
            "fax_number": "484-472-6562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANZANESE",
        "first_name": "MARY",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP039153L",
            "primary": false
        },
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "PA",
            "license": "RP-039513L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FITZGERALD",
            "prefix": "MRS.",
            "credential": "RPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle Lauren Burke
• Lynn Butler
• Amy Calamita, PHARMD
• Dana Marie Calderoni, DPT
• Alessia Grace Callahan
• Kenneth Robert Carroll, PH.D.
• Jennifer Lynn Carter, PHARMD
• Susan Caspari
• Sarah W. Chenkin, PH.D.
• Thomas Lawrence Chermol Jr., DDS

• Pharmacist in Swarthmore, PA
• Providers in Swarthmore, PA by specialty
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.