Healthcare Provider Details

I. General information

NPI: 1215240056
Provider Name (Legal Business Name): SHAHNAZ TOOSSI WINTERS RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2010
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 ROUTE 130 N SUITE 1408
CINNAMINSON NJ
08077-3046
US

IV. Provider business mailing address

116 PINE CONE TRL
MEDFORD NJ
08055-9166
US

V. Phone/Fax

Practice location:
  • Phone: 856-829-7200
  • Fax: 856-829-0464
Mailing address:
  • Phone: 609-654-4507
  • Fax: 856-829-0464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02055000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: