Provider Demographics
NPI:1417003302
Name:PERCHAK, GEORGE J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:J
Last Name:PERCHAK
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 1:51 CONTINENTAL RD
Mailing Address - Street 2:
Mailing Address - City:WEST MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07480-1818
Mailing Address - Country:US
Mailing Address - Phone:973-728-5089
Mailing Address - Fax:
Practice Address - Street 1:51 CONTINENTAL RD
Practice Address - Street 2:
Practice Address - City:WEST MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07480-1818
Practice Address - Country:US
Practice Address - Phone:973-728-5089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02168000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist