Provider Demographics
NPI:1346535242
Name:GORIEL, ANGELIKA
Entity Type:Individual
Prefix:
First Name:ANGELIKA
Middle Name:
Last Name:GORIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18000 VERNIER RD
Mailing Address - Street 2:T-0776
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-1046
Mailing Address - Country:US
Mailing Address - Phone:313-308-1006
Mailing Address - Fax:
Practice Address - Street 1:18000 VERNIER RD
Practice Address - Street 2:T-0776
Practice Address - City:HARPER WOODS
Practice Address - State:MI
Practice Address - Zip Code:48225-1046
Practice Address - Country:US
Practice Address - Phone:313-308-1006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist