Provider Demographics
NPI:1790961324
Name:SEMO, STEPHEN EDWARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:EDWARD
Last Name:SEMO
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 1:3132 SIMMONS RD
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:NY
Mailing Address - Zip Code:14530-9538
Mailing Address - Country:US
Mailing Address - Phone:585-237-5658
Mailing Address - Fax:
Practice Address - Street 1:6265 BROCKPORT SPENCERPORT RD
Practice Address - Street 2:
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420-2605
Practice Address - Country:US
Practice Address - Phone:585-637-2341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist