Healthcare Provider Details

I. General information

NPI: 1912280736
Provider Name (Legal Business Name): OKSANA ZATUCHNY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 MAGNOLIA WAY
NORTH HALEDON NJ
07508-3113
US

IV. Provider business mailing address

42 MAGNOLIA WAY
NORTH HALEDON NJ
07508-3113
US

V. Phone/Fax

Practice location:
  • Phone: 201-921-2400
  • Fax:
Mailing address:
  • Phone: 201-921-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03344300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: