Provider Demographics
NPI:1740262922
Name:STANIEC, RICHARD D (RPH)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:D
Last Name:STANIEC
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 1:113 RED STONE RDG
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-2031
Mailing Address - Country:US
Mailing Address - Phone:856-764-7161
Mailing Address - Fax:
Practice Address - Street 1:113 RED STONE RDG
Practice Address - Street 2:
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-2031
Practice Address - Country:US
Practice Address - Phone:856-764-7161
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP030267L183500000X
NJRI02896500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist