Provider Demographics
NPI:1376266478
Name:PIELKA, GABRIELLE LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GABRIELLE
Middle Name:LYNN
Last Name:PIELKA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 LAKE FRONT PL APT 202
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-2722
Mailing Address - Country:US
Mailing Address - Phone:201-661-3025
Mailing Address - Fax:
Practice Address - Street 1:608 LAKE FRONT PL APT 202
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-2722
Practice Address - Country:US
Practice Address - Phone:201-661-3025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202220642183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202220642OtherVIRGINIA BOARD OF PHARMACY