MEDICARE: MRS. NERINA M STOECKEL RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RI18784	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RI18784	OTHER	NJ	PHARMACIST LICENSE NUMBER

General Provider Information

NPI Number	:	1508044769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NERINA M STOECKEL RPH

Provider Business Mailing Address
First Line	:	561 ROUTE 1 UNIT B
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-4400
Country	:	US
Telephone Number	:	732-572-4340
Fax Number	:	732-819-9160

Provider Business Practice Location Address
First Line	:	561 ROUTE 1 UNIT B
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-4400
Country	:	US
Telephone Number	:	732-572-4340
Fax Number	:	732-819-9160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2008
Last Update Date	:	06/05/2012

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