Provider Demographics
NPI:1922403591
Name:SENCHYSHAK, PETE (RPH)
Entity Type:Individual
Prefix:
First Name:PETE
Middle Name:
Last Name:SENCHYSHAK
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 1:2438 LAUREL RD E
Mailing Address - Street 2:
Mailing Address - City:NORTH VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34275-3204
Mailing Address - Country:US
Mailing Address - Phone:941-488-2459
Mailing Address - Fax:941-234-0986
Practice Address - Street 1:2438 LAUREL RD E
Practice Address - Street 2:
Practice Address - City:NORTH VENICE
Practice Address - State:FL
Practice Address - Zip Code:34275-3204
Practice Address - Country:US
Practice Address - Phone:941-488-2459
Practice Address - Fax:941-234-0986
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-25
Last Update Date:2014-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48870183500000X
PARP037665L183500000X
OH03127744183500000X
SCPH14046183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS48870OtherFLORIDA PHARMACY LICENSE