Provider Demographics
NPI:1093728354
Name:STRASNICK, ELLIOT MARVIN (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:ELLIOT
Middle Name:MARVIN
Last Name:STRASNICK
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 VILLAGE PLZ
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-2373
Mailing Address - Country:US
Mailing Address - Phone:781-631-8100
Mailing Address - Fax:781-639-2919
Practice Address - Street 1:1 VILLAGE PLZ
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-2373
Practice Address - Country:US
Practice Address - Phone:781-631-8400
Practice Address - Fax:781-639-2919
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14178183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist