Provider Demographics
NPI:1265443329
Name:WINZELBERG, STUART (RPH)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:
Last Name:WINZELBERG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 ARDMORE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4323
Mailing Address - Country:US
Mailing Address - Phone:718-494-8919
Mailing Address - Fax:212-712-0918
Practice Address - Street 1:191 ARDMORE AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4323
Practice Address - Country:US
Practice Address - Phone:718-494-8919
Practice Address - Fax:212-712-0918
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032831183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01315879Medicaid