Provider Demographics
NPI:1275746158
Name:BEAN, STEPHEN A (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:A
Last Name:BEAN
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:STRONG MEMORIAL HOSPITAL
Mailing Address - Street 2:601 ELMWOOD AVE, BOX 638
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-6153
Mailing Address - Fax:
Practice Address - Street 1:STRONG MEMORIAL HOSPITAL
Practice Address - Street 2:601 ELMWOOD AVE, BOX 638
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-6153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35981183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist