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General NPI Number Information
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NPI Number | 1801477898
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Entity Type | Individual
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Provider Name | TRINA SUE STIFF CPHT
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Gender | Female
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Dates
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Enumeration Date | 04/20/2021
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 3920 BELL BLVD
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City | BAYSIDE
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State | NY
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Zip | 11361-2061
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Country | US
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Telephone | 718-224-2606
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Fax | 718-224-8083
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Provider Business Mailing Address
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Address Line | 21353 35TH AVE APT 1
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City | BAYSIDE
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State | NY
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Zip | 11361-1766
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Country | US
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Telephone | 718-306-4559
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 30138009
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License Number State | NY
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