Provider Demographics
NPI:1881970291
Name:VILLANO, MARIE OLIVIA (PHARM D)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:OLIVIA
Last Name:VILLANO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 WILKES BARRE TOWNSHIP BLVD
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-6162
Mailing Address - Country:US
Mailing Address - Phone:570-823-3363
Mailing Address - Fax:570-820-0341
Practice Address - Street 1:910 WILKES BARRE TOWNSHIP BLVD
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-6162
Practice Address - Country:US
Practice Address - Phone:570-823-3363
Practice Address - Fax:570-820-0341
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-30
Last Update Date:2011-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045996L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist