Provider Demographics
NPI:1356759922
Name:TERAK, EMILY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:TERAK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633D MEDICAL GROUP HOSPITAL
Mailing Address - Street 2:77 NEALY AVE, BUILDING 257
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23665
Mailing Address - Country:US
Mailing Address - Phone:757-225-6721
Mailing Address - Fax:
Practice Address - Street 1:77 NEALY AVE BLDG 257
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23665-2040
Practice Address - Country:US
Practice Address - Phone:757-225-6721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP448957183500000X
VA0202213244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist