Provider Demographics
NPI:1669076709
Name:EPPEL, SVYATOSLAV (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SVYATOSLAV
Middle Name:
Last Name:EPPEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 BOWMAN DR
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-1602
Mailing Address - Country:US
Mailing Address - Phone:267-304-3427
Mailing Address - Fax:
Practice Address - Street 1:401 SPRING GARDEN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-2818
Practice Address - Country:US
Practice Address - Phone:215-418-3065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444870183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist