Provider Demographics
NPI:1508044769
Name:STOECKEL, NERINA M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NERINA
Middle Name:M
Last Name:STOECKEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 ROUTE 1 UNIT B
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-4400
Mailing Address - Country:US
Mailing Address - Phone:732-572-4340
Mailing Address - Fax:732-819-9160
Practice Address - Street 1:561 ROUTE 1 UNIT B
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-4400
Practice Address - Country:US
Practice Address - Phone:732-572-4340
Practice Address - Fax:732-819-9160
Is Sole Proprietor?:No
Enumeration Date:2008-02-09
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRI18784183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJRI18784OtherPHARMACIST LICENSE NUMBER