Healthcare Provider Details

I. General information

NPI: 1578961371
Provider Name (Legal Business Name): JEFFREY RYZOFF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2014
Last Update Date: 12/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 MAIN ST
BEDMINSTER NJ
07921-2605
US

IV. Provider business mailing address

405 MAIN ST
BEDMINSTER NJ
07921-2605
US

V. Phone/Fax

Practice location:
  • Phone: 908-234-1101
  • Fax: 908-234-1103
Mailing address:
  • Phone: 908-234-1101
  • Fax: 908-234-1103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI01993100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: