Individual
AGI RECI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-2500
Mailing address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-2500
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
04/01/2022
Last updated
04/21/2022
About Stedi
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