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NPI Code Detail

MEDICARE: MR. KENNETH JOHN STEBNER

MEDICARE: MR. KENNETH JOHN STEBNER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835G0303XGeriatric PharmacistRP040262LPA

General Provider Information

NPI Number : 1336721547
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KENNETH JOHN STEBNER
Provider Business Mailing Address
First Line : 340 N MIDDLETOWN RD
Second Line :
City : MEDIA
State : PA
Zip : 19063-5505
Country : US
Telephone Number : 610-891-5859
Fax Number : 610-891-5860
Provider Business Practice Location Address
First Line : 340 N MIDDLETOWN RD
Second Line :
City : MEDIA
State : PA
Zip : 19063-5505
Country : US
Telephone Number : 610-891-5859
Fax Number : 610-891-5860
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2021
Last Update Date : 04/27/2021

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Directions to “ MR. KENNETH JOHN STEBNER ” Practice Location

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