Provider Demographics
NPI:1376975896
Name:STUDLACK, GEORGE PATRICK (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:PATRICK
Last Name:STUDLACK
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:792 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14611-2343
Mailing Address - Country:US
Mailing Address - Phone:585-235-2726
Mailing Address - Fax:
Practice Address - Street 1:792 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611-2343
Practice Address - Country:US
Practice Address - Phone:585-235-2726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI058028-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist