Provider Demographics
NPI:1487968640
Name:STEDINA, DOROTA MAGDALENA (PHARMD)
Entity type:Individual
Prefix:
First Name:DOROTA
Middle Name:MAGDALENA
Last Name:STEDINA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1101
Mailing Address - Country:US
Mailing Address - Phone:718-541-4144
Mailing Address - Fax:
Practice Address - Street 1:1346 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11239-2103
Practice Address - Country:US
Practice Address - Phone:718-642-2727
Practice Address - Fax:718-642-0679
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054835183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist