Healthcare Provider Details

I. General information

NPI: 1790894491
Provider Name (Legal Business Name): ARTHUR SCOT BARTHOLD R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 06/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 KINDERKAMACK RD
PARK RIDGE NJ
07656-1335
US

IV. Provider business mailing address

30 LINCOLN PL
WALDWICK NJ
07463-1924
US

V. Phone/Fax

Practice location:
  • Phone: 201-391-3232
  • Fax: 201-930-9672
Mailing address:
  • Phone: 201-447-2175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15955
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: