Provider Demographics
NPI:1033710454
Name:STUYVESANT, SYDNEY ANNE (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:ANNE
Last Name:STUYVESANT
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 YVERDON DR APT B5
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1285
Mailing Address - Country:US
Mailing Address - Phone:717-315-8675
Mailing Address - Fax:
Practice Address - Street 1:60 NOBLE BLVD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-4119
Practice Address - Country:US
Practice Address - Phone:717-258-4252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP452518183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist