Provider Demographics
NPI:1265612311
Name:STERBER, PATRICIA A
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:STERBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 CORNHILL PL
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14608-2297
Mailing Address - Country:US
Mailing Address - Phone:585-546-6045
Mailing Address - Fax:
Practice Address - Street 1:125 WHITE SPRUCE BLVD
Practice Address - Street 2:RITE AID
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1607
Practice Address - Country:US
Practice Address - Phone:585-424-6550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042161-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00446979Medicaid