Healthcare Provider Details

I. General information

NPI: 1326972332
Provider Name (Legal Business Name): ALICIA M NORDBERG-PAYNE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

337 W WASHINGTON AVE
MAGNOLIA NJ
08049-1705
US

IV. Provider business mailing address

337 W WASHINGTON AVE
MAGNOLIA NJ
08049-1705
US

V. Phone/Fax

Practice location:
  • Phone: 267-879-3777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRP456775
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: