Provider Demographics
NPI:1578744561
Name:CZECHOWSKI, E. LOUIS JR (R PH)
Entity Type:Individual
Prefix:MR
First Name:E.
Middle Name:LOUIS
Last Name:CZECHOWSKI
Suffix:JR
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6642 BLUE HEATHER CT
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-8493
Mailing Address - Country:US
Mailing Address - Phone:610-428-6868
Mailing Address - Fax:610-965-6808
Practice Address - Street 1:6642 BLUE HEATHER CT
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-8493
Practice Address - Country:US
Practice Address - Phone:610-428-6868
Practice Address - Fax:610-965-6808
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-18
Last Update Date:2007-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP041375L1835G0303X
DEA100028591835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric