Healthcare Provider Details

I. General information

NPI: 1629279369
Provider Name (Legal Business Name): STEVEN L GELWAN R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 E 86TH ST APARTMENT 31B
NEW YORK NY
10028-6458
US

IV. Provider business mailing address

444 E 86TH ST APARTMENT 31B
NEW YORK NY
10028-6458
US

V. Phone/Fax

Practice location:
  • Phone: 212-879-5736
  • Fax:
Mailing address:
  • Phone: 212-879-5736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number037887
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: