Healthcare Provider Details

I. General information

NPI: 1497004048
Provider Name (Legal Business Name): REBECCA GRELLA RPH, PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3666 NYS RTE 281
CORTLAND NY
13045-4518
US

IV. Provider business mailing address

3666 NYS RTE 281
CORTLAND NY
13045-4518
US

V. Phone/Fax

Practice location:
  • Phone: 607-753-9359
  • Fax: 844-544-7239
Mailing address:
  • Phone: 607-753-9359
  • Fax: 844-544-7239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number056967
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: