Healthcare Provider Details

I. General information

NPI: 1255499851
Provider Name (Legal Business Name): JEFFREY ALLEN REITZ PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD ROOM LE15
NEWARK DE
19718-0002
US

IV. Provider business mailing address

4755 OGLETOWN STANTON RD ROOM LE15
NEWARK DE
19718-0002
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-6364
  • Fax:
Mailing address:
  • Phone: 302-733-6364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberA10002805
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberA10002805
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: