Provider Demographics
NPI:1871777052
Name:CARRATU, STEPHANIE (RPH)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:CARRATU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WILSON PL
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-5935
Mailing Address - Country:US
Mailing Address - Phone:631-592-1327
Mailing Address - Fax:
Practice Address - Street 1:1850 VETERANS MEMORIAL HWY
Practice Address - Street 2:WALMART PHARMACY
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749
Practice Address - Country:US
Practice Address - Phone:631-851-1183
Practice Address - Fax:631-851-1193
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043006183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist