Provider Demographics
NPI:1629279369
Name:GELWAN, STEVEN L (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:L
Last Name:GELWAN
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 1:444 E 86TH ST
Mailing Address - Street 2:APARTMENT 31B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-6458
Mailing Address - Country:US
Mailing Address - Phone:212-879-5736
Mailing Address - Fax:
Practice Address - Street 1:444 E 86TH ST
Practice Address - Street 2:APARTMENT 31B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-6458
Practice Address - Country:US
Practice Address - Phone:212-879-5736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037887183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist