Provider Demographics
NPI:1598047649
Name:SIEMERS, STEVEN A (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:A
Last Name:SIEMERS
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 1:17 NUTMEG CT
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-7022
Mailing Address - Country:US
Mailing Address - Phone:732-614-5723
Mailing Address - Fax:
Practice Address - Street 1:520 CONVERY BLVD
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3021
Practice Address - Country:US
Practice Address - Phone:732-826-9222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02679300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist