Provider Demographics
NPI:1043509342
Name:LE, DANIELA (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:LE
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 1:807 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19526-9200
Mailing Address - Country:US
Mailing Address - Phone:610-562-9454
Mailing Address - Fax:610-562-2799
Practice Address - Street 1:807 S 4TH ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:PA
Practice Address - Zip Code:19526-9200
Practice Address - Country:US
Practice Address - Phone:610-562-9454
Practice Address - Fax:610-562-2799
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040039L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist