Provider Demographics
NPI:1407949282
Name:ZALESKI, RAYMOND ALBERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:ALBERT
Last Name:ZALESKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-4309
Mailing Address - Country:US
Mailing Address - Phone:765-966-5544
Mailing Address - Fax:765-966-1497
Practice Address - Street 1:631 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-4309
Practice Address - Country:US
Practice Address - Phone:765-966-5544
Practice Address - Fax:765-966-1497
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26014436183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist