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General NPI Number Information
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NPI Number | 1912540790
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Entity Type | Individual
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Provider Name | GREGORI PETER ANELLI
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Gender | Male
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Dates
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Enumeration Date | 10/23/2019
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 300 LINCOLN AVE
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-2815
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Country | US
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Telephone | 570-459-5759
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Fax |
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Provider Business Mailing Address
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Address Line | 70 S LOCUST ST
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City | HAZLETON
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State | PA
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Zip | 18201-6100
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Country | US
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Telephone | 570-459-5759
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Fax | 570-459-6038
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP041251L
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License Number State | PA
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