Provider Demographics
NPI:1669953295
Name:NEMETH, STEPHEN WILLIAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:WILLIAM
Last Name:NEMETH
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 1:36 BLACKWATCH TRL
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-3702
Mailing Address - Country:US
Mailing Address - Phone:585-200-7090
Mailing Address - Fax:
Practice Address - Street 1:211 BAILEY RD
Practice Address - Street 2:
Practice Address - City:WEST HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14586-9728
Practice Address - Country:US
Practice Address - Phone:585-200-7090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064226183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist