Provider Demographics
NPI:1467790345
Name:REISS, ROBERT ADRIAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ADRIAN
Last Name:REISS
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 1:1425 PORTLAND AVE
Mailing Address - Street 2:ROCHESTER GENERAL HOSPITAL DEPT OF PHARMACY
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3095
Mailing Address - Country:US
Mailing Address - Phone:585-922-5746
Mailing Address - Fax:585-922-3730
Practice Address - Street 1:1425 PORTLAND AVE
Practice Address - Street 2:ROCHESTER GENERAL HOSPITAL DEPT OF PHARMACY
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3001
Practice Address - Country:US
Practice Address - Phone:585-922-5746
Practice Address - Fax:585-922-3730
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35201183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist