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General NPI Number Information
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NPI Number | 1093894701
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Entity Type | Individual
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Provider Name | ANTHONY CARL STELLATO RPH
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Gender | Male
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 09/24/2010
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Provider Practice Location Address
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Address Line | 3 PENNSYLVANIA AVE E THE MEDICINE SHOPPE
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City | WARREN
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State | PA
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Zip | 16365-2526
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Country | US
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Telephone | 814-726-3741
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Fax | 814-726-3716
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Provider Business Mailing Address
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Address Line | 29 VALLEY VIEW DR
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City | RUSSELL
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State | PA
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Zip | 16345-4053
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Country | US
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Telephone | 814-757-9418
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Fax | 814-726-3716
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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 | RP033753L
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License Number State | PA
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