Provider Demographics
NPI:1386852325
Name:TEPPER, STEVEN (RPH)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:TEPPER
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 1:333 E LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-1929
Mailing Address - Country:US
Mailing Address - Phone:610-649-0390
Mailing Address - Fax:610-949-9229
Practice Address - Street 1:333 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-1929
Practice Address - Country:US
Practice Address - Phone:610-649-0390
Practice Address - Fax:610-949-9229
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP411529L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000561120 0001Medicaid
PA000561120 0001Medicaid