Provider Demographics
NPI:1588745517
Name:EILERMAN, STEFANIE (PHARMD)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:EILERMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:
Other - Last Name:VITALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:831 ANNADALE RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-3133
Mailing Address - Country:US
Mailing Address - Phone:718-227-0710
Mailing Address - Fax:
Practice Address - Street 1:831 ANNADALE RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-3133
Practice Address - Country:US
Practice Address - Phone:718-227-0710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02834900183500000X
NY047166183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist