Healthcare Provider Details

I. General information

NPI: 1770866899
Provider Name (Legal Business Name): ANGELIKA KOT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2011
Last Update Date: 09/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 ROUTE 70 W
CHERRY HILL NJ
08002-3206
US

IV. Provider business mailing address

1819 ROUTE 70 W
CHERRY HILL NJ
08002-3206
US

V. Phone/Fax

Practice location:
  • Phone: 856-662-3685
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03014600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: