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Individual
MR. GARY STAVIN
Active
Individual
MR. GARY STAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
045178
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02242419
—
NY
Enumeration date
03/08/2010
Last updated
03/08/2010
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