Provider Demographics
NPI:1710353248
Name:KINTU, STELLA N (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STELLA
Middle Name:N
Last Name:KINTU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 DALE BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-2243
Mailing Address - Country:US
Mailing Address - Phone:703-878-1837
Mailing Address - Fax:866-412-3880
Practice Address - Street 1:4215 DALE BLVD
Practice Address - Street 2:TDS HEALTH
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-2243
Practice Address - Country:US
Practice Address - Phone:703-897-1837
Practice Address - Fax:703-897-4862
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012960183500000X, 1835G0303X, 1835P1200X, 1835P0018X
DCPH1000018941835P1200X, 1835P1300X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No1835X0200XPharmacy Service ProvidersPharmacistOncology