Provider Demographics
NPI:1588146096
Name:DUERMEYER, STEPHANIE (PHARMD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:DUERMEYER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4111 TONAWANDA CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-9546
Mailing Address - Country:US
Mailing Address - Phone:716-525-7019
Mailing Address - Fax:
Practice Address - Street 1:4111 TONAWANDA CREEK RD
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-9546
Practice Address - Country:US
Practice Address - Phone:716-525-7019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064562183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist