Provider Demographics
NPI:1447573787
Name:PORANSKI, EDWARD JON (RPH)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JON
Last Name:PORANSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 PEACH ST
Mailing Address - Street 2:UNIT 200
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-4754
Mailing Address - Country:US
Mailing Address - Phone:814-866-0984
Mailing Address - Fax:814-866-0986
Practice Address - Street 1:7200 PEACH ST
Practice Address - Street 2:UNIT 200
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-4754
Practice Address - Country:US
Practice Address - Phone:814-866-0984
Practice Address - Fax:814-866-0986
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439142183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist