Provider Demographics
NPI:1134676604
Name:DREY, MARK DANA (RPHPENNSYLVANIA)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:DANA
Last Name:DREY
Suffix:
Gender:M
Credentials:RPHPENNSYLVANIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 S 4TH ST, STE A
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-4929
Mailing Address - Country:US
Mailing Address - Phone:484-860-3227
Mailing Address - Fax:610-351-0725
Practice Address - Street 1:1932 S 4TH ST, STE A
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-4929
Practice Address - Country:US
Practice Address - Phone:484-860-3227
Practice Address - Fax:610-351-0725
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032291L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist