Healthcare Provider Details

I. General information

NPI: 1538420518
Provider Name (Legal Business Name): ANDREW KAPLAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2012
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 HWY 35
CLIFFWOOD NJ
07721-1177
US

IV. Provider business mailing address

325 HWY 35
CLIFFWOOD NJ
07721-1177
US

V. Phone/Fax

Practice location:
  • Phone: 732-441-9100
  • Fax: 732-441-7454
Mailing address:
  • Phone: 732-441-9100
  • Fax: 732-441-7454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02273900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: