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NPI Code Detail

MEDICARE: STEFANIE MARIE ANGRISANO PHARMD

MEDICARE: STEFANIE MARIE ANGRISANO PHARMD
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
1183500000XPharmacist18101NV

General Provider Information

NPI Number : 1629352505
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEFANIE MARIE ANGRISANO PHARMD
Provider Business Mailing Address
First Line : 2630 HEATHROW ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89135-2603
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2280 N LAS VEGAS BLVD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-5803
Country : US
Telephone Number : 702-649-1415
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2011
Last Update Date : 10/10/2011

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Directions to “ STEFANIE MARIE ANGRISANO PHARMD” Practice Location

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