Provider Demographics
NPI:1891964094
Name:STERN, DEBBIE ELIZABETH (BS)
Entity type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:ELIZABETH
Last Name:STERN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2875 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5811
Mailing Address - Country:US
Mailing Address - Phone:718-761-8484
Mailing Address - Fax:718-370-8863
Practice Address - Street 1:54 MILLAY RD
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1452
Practice Address - Country:US
Practice Address - Phone:732-617-1255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY047200OtherPHARMACIST