Provider Demographics
NPI:1225663602
Name:GYURCSIK, FARZANEH (RPH)
Entity Type:Individual
Prefix:
First Name:FARZANEH
Middle Name:
Last Name:GYURCSIK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:FARA
Other - Middle Name:
Other - Last Name:GYURCSIK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:2826 DONCASTER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-3034
Mailing Address - Country:US
Mailing Address - Phone:614-361-7831
Mailing Address - Fax:
Practice Address - Street 1:2826 DONCASTER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-3034
Practice Address - Country:US
Practice Address - Phone:614-361-7831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03323896183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist