Provider Demographics
NPI:1932654001
Name:STANZESKI, NICHOLAS (PHARMD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:STANZESKI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14525 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:EAST CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-3426
Mailing Address - Country:US
Mailing Address - Phone:216-851-1472
Mailing Address - Fax:
Practice Address - Street 1:14525 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-3426
Practice Address - Country:US
Practice Address - Phone:216-851-1472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-18
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03334854183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist