Provider Demographics
NPI:1013194646
Name:CRETEKOS, PETER STEVEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:STEVEN
Last Name:CRETEKOS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-3211
Mailing Address - Country:US
Mailing Address - Phone:845-855-9749
Mailing Address - Fax:
Practice Address - Street 1:162 ROUTE 22
Practice Address - Street 2:
Practice Address - City:PAWLING
Practice Address - State:NY
Practice Address - Zip Code:12564-3211
Practice Address - Country:US
Practice Address - Phone:845-855-9749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32892183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist