Provider Demographics
NPI:1902076623
Name:CERASO, REGAN D (RPH)
Entity Type:Individual
Prefix:MRS
First Name:REGAN
Middle Name:D
Last Name:CERASO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GAMMA DRIVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-1038
Mailing Address - Country:US
Mailing Address - Phone:412-449-0680
Mailing Address - Fax:
Practice Address - Street 1:100 GAMMA DRIVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-1038
Practice Address - Country:US
Practice Address - Phone:412-449-0680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP041773L1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric