Provider Demographics
NPI:1871063123
Name:CITSAY, BRUCE ALEXANDER (RPH)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:ALEXANDER
Last Name:CITSAY
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 1:521 S LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-2740
Mailing Address - Country:US
Mailing Address - Phone:717-626-4296
Mailing Address - Fax:
Practice Address - Street 1:1643 MANHEIM PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3027
Practice Address - Country:US
Practice Address - Phone:717-569-7518
Practice Address - Fax:717-560-8397
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist