Provider Demographics
NPI:1285933408
Name:GRELAK, ROBERT PAUL (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:PAUL
Last Name:GRELAK
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 1:19 DECKER DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-3810
Mailing Address - Country:US
Mailing Address - Phone:302-731-1386
Mailing Address - Fax:
Practice Address - Street 1:19 DECKER DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-3810
Practice Address - Country:US
Practice Address - Phone:302-731-1386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0001458183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEA1-0001458OtherDELAWARE RPH LICENSE