Healthcare Provider Details

I. General information

NPI: 1518680560
Provider Name (Legal Business Name): MRS. MARIANNE KILMURRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2022
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 RIVER RD
NEW MILFORD NJ
07646-3097
US

IV. Provider business mailing address

880 RIVER RD
NEW MILFORD NJ
07646-3097
US

V. Phone/Fax

Practice location:
  • Phone: 201-225-2101
  • Fax:
Mailing address:
  • Phone: 201-225-2101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02539000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: