Healthcare Provider Details

I. General information

NPI: 1629246178
Provider Name (Legal Business Name): ANNETTE KHERLOPIAN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 DEMAREST AVE
CLOSTER NJ
07624
US

IV. Provider business mailing address

400 DEMAREST AVE
CLOSTER NJ
07624-2513
US

V. Phone/Fax

Practice location:
  • Phone: 201-784-7190
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03021600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: