Basic Information
| Provider Information | |||||||||
| NPI: | 1548840754 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUKSA | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1305 WEST CHESTER PIKE | ||||||||
| Address2: | SUITE 8 | ||||||||
| City: | HAVERTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190832929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104462795 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 160 EAST ERIE AVE | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191341011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154275000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2021 | ||||||||
| LastUpdateDate: | 09/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 09/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 19888 | AL | N | Pharmacy Service Providers | Pharmacist | 183500000X | RP454172 | PA | Y | Pharmacy Service Providers | Pharmacist | 183500000X | 28RI04142100 | NJ | N | Pharmacy Service Providers | Pharmacist | 183500000X | 0202215940 | VA | N | Pharmacy Service Providers | Pharmacist | 183500000X | A1-0015509 | DE | N | Pharmacy Service Providers | Pharmacist | 183500000X | 66714 | TX | N | Pharmacy Service Providers | Pharmacist |
No ID Information.