Provider Demographics
NPI:1790533974
Name:PLAZEK, GREGORY PAUL SR
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:PAUL
Last Name:PLAZEK
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1089 SAGRAMORE DR N
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-4622
Mailing Address - Country:US
Mailing Address - Phone:234-284-3741
Mailing Address - Fax:
Practice Address - Street 1:1089 SAGRAMORE DR N
Practice Address - Street 2:
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-4622
Practice Address - Country:US
Practice Address - Phone:234-284-3741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-11
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)