Provider Demographics
NPI:1790007367
Name:STANILEWICZ, JOSEPH T (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:T
Last Name:STANILEWICZ
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 1:75 NASSAU TERMINAL RD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4927
Mailing Address - Country:US
Mailing Address - Phone:516-280-1000
Mailing Address - Fax:516-280-1087
Practice Address - Street 1:75 NASSAU TERMINAL RD
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-4927
Practice Address - Country:US
Practice Address - Phone:516-280-1000
Practice Address - Fax:516-280-1087
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY37590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist