Healthcare Provider Details

I. General information

NPI: 1215672076
Provider Name (Legal Business Name): ESTHER DE FREUDIGER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 HILLSIDE BLVD
LAKEWOOD NJ
08701-3148
US

IV. Provider business mailing address

76 BRADHURST AVE
LAKEWOOD NJ
08701-6134
US

V. Phone/Fax

Practice location:
  • Phone: 732-370-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04188700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: