Healthcare Provider Details

I. General information

NPI: 1639451768
Provider Name (Legal Business Name): DANIELLE BOBACHER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 09/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 WASHINGTON AVE
HILLSDALE NJ
07642-2735
US

IV. Provider business mailing address

576 NORTHERN PKWY
RIDGEWOOD NJ
07450-1739
US

V. Phone/Fax

Practice location:
  • Phone: 201-664-4250
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03117400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS41375
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: