Provider Demographics
NPI:1205414489
Name:VELLKY, RAYMOND (PHARMD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:VELLKY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5121 CARNEGIE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-2533
Mailing Address - Country:US
Mailing Address - Phone:412-620-3437
Mailing Address - Fax:
Practice Address - Street 1:211 52ND ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15201-2531
Practice Address - Country:US
Practice Address - Phone:412-620-3437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453450183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist