Provider Demographics
NPI:1144452657
Name:KOZMINSKI, MELINDA ELISE (PHARMD)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:ELISE
Last Name:KOZMINSKI
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 1:736 SALK HL
Mailing Address - Street 2:3501 TERRACE STREET
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15261-0001
Mailing Address - Country:US
Mailing Address - Phone:412-383-7267
Mailing Address - Fax:412-624-8175
Practice Address - Street 1:900 MOUNT ROYAL BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15223-1060
Practice Address - Country:US
Practice Address - Phone:412-487-2173
Practice Address - Fax:412-487-6091
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist