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General NPI Number Information
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NPI Number | 1013644376
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Entity Type | Individual
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Provider Name | STEPHANIE LARISSA OSTIR RPH
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Gender | Female
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Dates
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Enumeration Date | 08/05/2022
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 5879 STATE ROUTE 92 STE 3
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City | KINGSLEY
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State | PA
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Zip | 18826-9707
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Country | US
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Telephone | 570-222-5005
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Fax |
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Provider Business Mailing Address
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Address Line | 907 SCHOOLHOUSE RD
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City | CLIFFORD TWP
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State | PA
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Zip | 18470-7556
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Country | US
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Telephone | 570-807-6713
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP456958
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License Number State | PA
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