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General NPI Number Information
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NPI Number | 1750661336
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Entity Type | Individual
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Provider Name | STEPHANIE GABURO
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Gender | Female
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Dates
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Enumeration Date | 08/26/2011
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Last Update Date | 08/26/2011
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Provider Practice Location Address
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Address Line | 2006 HWY 35
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City | SPRING LAKE
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State | NJ
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Zip | 07762-2543
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Country | US
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Telephone | 732-282-0719
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Fax |
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Provider Business Mailing Address
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Address Line | 591 SHELDON AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-2728
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Country | US
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Telephone |
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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 | 28RI03438100
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License Number State | NJ
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