Healthcare Provider Details

I. General information

NPI: 1649502865
Provider Name (Legal Business Name): CHERIE GELA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2010
Last Update Date: 02/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PAGE AVE
STATEN ISLAND NY
10307-1113
US

IV. Provider business mailing address

13 ESTHER DEPEW ST
STATEN ISLAND NY
10306-1209
US

V. Phone/Fax

Practice location:
  • Phone: 718-966-6606
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0490961
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02557100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: