Mark Andrew Bucciarelli
Individual provider Active NPI Pharmacist · Mars, PA
NPI 1205201787 · NPPES record last updated Dec 9, 2015
Key facts
- NPI
- 1205201787
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RP450033 (PA)
- Practice address
- 129 Grand Ave
Mars, PA 16046 - Phone
- (724) 625-3196
- NPI assigned
- Dec 9, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP450033 | PA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP450033 | PA | Yes |
Addresses
Primary practice location
129 Grand Ave
Mars, PA 16046
Mailing address
111 Rylie Dr
Harmony, PA 16037-7764
Other providers in Mars, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.