Provider Demographics
NPI:1073027728
Name:GROSS, AURELIA NICOLETTA (PHARMD)
Entity Type:Individual
Prefix:
First Name:AURELIA
Middle Name:NICOLETTA
Last Name:GROSS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6450
Mailing Address - Country:US
Mailing Address - Phone:845-926-7685
Mailing Address - Fax:
Practice Address - Street 1:3441 KILDAIRE FARM RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-1545
Practice Address - Country:US
Practice Address - Phone:919-387-4124
Practice Address - Fax:919-387-0841
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist