Healthcare Provider Details

I. General information

NPI: 1376454272
Provider Name (Legal Business Name): COREY RENEE GRAZIADE PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COREY RENEE ANAUO PHARMD, RPH

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 NEW SCOTLAND AVE STE 106
ALBANY NY
12208-3560
US

IV. Provider business mailing address

17 EASTMOUNT DR APT 170
SLINGERLANDS NY
12159-2173
US

V. Phone/Fax

Practice location:
  • Phone: 518-649-9672
  • Fax: 518-649-9673
Mailing address:
  • Phone: 518-225-7110
  • Fax: 518-225-7110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberI074429-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: