Healthcare Provider Details

I. General information

NPI: 1669385308
Provider Name (Legal Business Name): KATHERINE MARY STEWART PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 MIDDLEVILLE RD
NORTHPORT NY
11768-2200
US

IV. Provider business mailing address

260 WHITTIER AVE
FLORAL PARK NY
11001-1204
US

V. Phone/Fax

Practice location:
  • Phone: 631-261-4400
  • Fax:
Mailing address:
  • Phone: 516-305-7735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number074556
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: