Provider Demographics
NPI:1336328251
Name:GRYKO, GEORGE JOHN (RPH)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:JOHN
Last Name:GRYKO
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 1:3950 UNION RD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-4252
Mailing Address - Country:US
Mailing Address - Phone:716-634-3603
Mailing Address - Fax:716-634-9724
Practice Address - Street 1:3950 UNION RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4252
Practice Address - Country:US
Practice Address - Phone:716-634-3603
Practice Address - Fax:716-634-9724
Is Sole Proprietor?:No
Enumeration Date:2007-10-27
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034352183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist