Provider Demographics
NPI:1366875429
Name:SEIGLER, STEPHEN (RPH)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:SEIGLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 HICKORY DR
Mailing Address - Street 2:SUITE-1
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1011
Mailing Address - Country:US
Mailing Address - Phone:781-373-9199
Mailing Address - Fax:781-609-2484
Practice Address - Street 1:69 HICKORY DR
Practice Address - Street 2:SUITE-1
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1011
Practice Address - Country:US
Practice Address - Phone:781-373-9199
Practice Address - Fax:781-609-2484
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH188111835G0303X
VT033.00529611835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric