Provider Demographics
NPI:1265716658
Name:BERLINER, STUART L (BS PHARM)
Entity type:Individual
Prefix:MR
First Name:STUART
Middle Name:L
Last Name:BERLINER
Suffix:
Gender:M
Credentials:BS PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7845 W FLAMINGO RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-4219
Mailing Address - Country:US
Mailing Address - Phone:702-871-1905
Mailing Address - Fax:702-871-2604
Practice Address - Street 1:7845 W FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-4219
Practice Address - Country:US
Practice Address - Phone:702-871-1905
Practice Address - Fax:702-871-2604
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12908183500000X
UT52188521701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist