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General NPI Number Information
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NPI Number | 1689456816
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Entity Type | Individual
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Provider Name | LUSINE STEPANYAN
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Gender | Female
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Dates
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Enumeration Date | 10/23/2023
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 1855 W THUNDERBIRD RD
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City | PHOENIX
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State | AZ
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Zip | 85023-6308
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Country | US
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Telephone | 602-439-6862
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Fax |
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Provider Business Mailing Address
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Address Line | 6610 N 93RD AVE APT 2067
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City | GLENDALE
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State | AZ
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Zip | 85305-3192
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Country | US
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Telephone | 818-414-6340
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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 | S026733
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License Number State | AZ
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