Provider Demographics
NPI:1306014907
Name:KNAUER, STUART LESLIE (RPH)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:LESLIE
Last Name:KNAUER
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 1:8 S LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:WENONAH
Mailing Address - State:NJ
Mailing Address - Zip Code:08090-1823
Mailing Address - Country:US
Mailing Address - Phone:856-468-8413
Mailing Address - Fax:
Practice Address - Street 1:1450 CLEMENTS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-3067
Practice Address - Country:US
Practice Address - Phone:856-853-0248
Practice Address - Fax:856-853-6293
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01821500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI01821500OtherPHARMACIST