Healthcare Provider Details

I. General information

NPI: 1154472488
Provider Name (Legal Business Name): LOREN MARGARET BROOK PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LOREN MARGARET SPARANO PHARM.D.

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN-STANTON RD
NEWARK DE
19718-0001
US

IV. Provider business mailing address

23 WOODSTREAM CT
MANTUA NJ
08051-2141
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-3550
  • Fax: 302-733-3572
Mailing address:
  • Phone: 856-464-6805
  • Fax: 856-464-0150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0003516
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP439021
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02886800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: