Provider Demographics
NPI:1215609342
Name:NEITZELT, EMILY ANN (PHARMD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:NEITZELT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ANN
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:205 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-2138
Mailing Address - Country:US
Mailing Address - Phone:330-634-0688
Mailing Address - Fax:330-634-0691
Practice Address - Street 1:205 WEST AVE
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-2138
Practice Address - Country:US
Practice Address - Phone:330-634-0688
Practice Address - Fax:330-634-0691
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03237144183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist