Healthcare Provider Details

I. General information

NPI: 1699052894
Provider Name (Legal Business Name): STEVEN ESKIN PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2011
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W62N190 WASHINGTON AVE
CEDARBURG WI
53012-2779
US

IV. Provider business mailing address

W62N190 WASHINGTON AVE
CEDARBURG WI
53012-2779
US

V. Phone/Fax

Practice location:
  • Phone: 414-352-4969
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number10056
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: