Provider Demographics
NPI:1295969483
Name:STOLLER, ROBERT (RPH)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:STOLLER
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 1:51 FOREST RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-2948
Mailing Address - Country:US
Mailing Address - Phone:845-783-3399
Mailing Address - Fax:
Practice Address - Street 1:51 FOREST RD
Practice Address - Street 2:SUITE 211
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-2948
Practice Address - Country:US
Practice Address - Phone:845-783-3399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026504183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist