Provider Demographics
NPI:1801247127
Name:SKROSKI, GARY JOSEPH (RPH)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:JOSEPH
Last Name:SKROSKI
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 1:907 HIGH ST N
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-3762
Mailing Address - Country:US
Mailing Address - Phone:856-825-7742
Mailing Address - Fax:
Practice Address - Street 1:907 HIGH ST N
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-3762
Practice Address - Country:US
Practice Address - Phone:856-825-7742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28R0I1778900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist