Healthcare Provider Details

I. General information

NPI: 1750604260
Provider Name (Legal Business Name): PATRICIA FRUMENTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2010
Last Update Date: 03/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 RIDGEGALE AVE
EAST HANOVER NJ
07936
US

IV. Provider business mailing address

30 N GATE RD
MENDHAM NJ
07945-3107
US

V. Phone/Fax

Practice location:
  • Phone: 973-463-3301
  • Fax:
Mailing address:
  • Phone: 973-813-7343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051380
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: