Healthcare Provider Details
I. General information
NPI: 1952883514
Provider Name (Legal Business Name): MERISSA MARIE RINGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/30/2018
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20 JACKSON ST STE E
FREEHOLD NJ
07728-2476
US
IV. Provider business mailing address
2612 SHADY GLEN AVE
POINT PLEASANT BORO NJ
08742-4243
US
V. Phone/Fax
- Phone: 732-363-6655
- Fax: 732-363-6656
- Phone: 724-207-3802
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | RP452660 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 28RI03957100 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: