Healthcare Provider Details

I. General information

NPI: 1649187923
Provider Name (Legal Business Name): KAITLYN VALENTINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CLEMENTS BRIDGE RD STE 10
DEPTFORD NJ
08096-2016
US

IV. Provider business mailing address

908 BURROUGHS MILL CIR
CHERRY HILL NJ
08002-1265
US

V. Phone/Fax

Practice location:
  • Phone: 856-384-6740
  • Fax: 856-384-6742
Mailing address:
  • Phone: 609-923-1307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP459918
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04508900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: