Provider Demographics
NPI:1255499851
Name:REITZ, JEFFREY ALLEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ALLEN
Last Name:REITZ
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 1:4755 OGLETOWN STANTON RD
Mailing Address - Street 2:ROOM LE15
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718-0002
Mailing Address - Country:US
Mailing Address - Phone:302-733-6364
Mailing Address - Fax:
Practice Address - Street 1:4755 OGLETOWN STANTON RD
Practice Address - Street 2:ROOM LE15
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-0002
Practice Address - Country:US
Practice Address - Phone:302-733-6364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA100028051835P1200X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy