MEDICARE: JANE SHTAYNBERG 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
1	183500000X	Pharmacist	20050724	NY
2	183500000X	Pharmacist	02932200	NJ

General Provider Information

NPI Number	:	1902129133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE SHTAYNBERG PHARMD

Provider Business Mailing Address
First Line	:	75 DEKALB AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5423
Country	:	US
Telephone Number	:	718-488-3469
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 DEKALB AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5423
Country	:	US
Telephone Number	:	718-488-3469
Fax Number	:

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

Provider Enumeration Date	:	03/02/2010
Last Update Date	:	06/14/2011

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