Healthcare Provider Details

I. General information

NPI: 1457768095
Provider Name (Legal Business Name): RICHARD MICHAEL CIUBINSKI JR. RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2014
Last Update Date: 07/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 TIMBERLINE RD
BAYVILLE NJ
08721-2173
US

IV. Provider business mailing address

82 TIMBERLINE RD
BAYVILLE NJ
08721-2173
US

V. Phone/Fax

Practice location:
  • Phone: 732-269-1161
  • Fax: 847-747-1555
Mailing address:
  • Phone: 732-269-1161
  • Fax: 847-747-1555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02239100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP044431R
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS28029
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: