Healthcare Provider Details

I. General information

NPI: 1457472888
Provider Name (Legal Business Name): THE RASA GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 12/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 SKYLINE DR SUITE 209
RINGWOOD NJ
07456-2037
US

IV. Provider business mailing address

55 SKYLINE DR SUITE 209
RINGWOOD NJ
07456-2037
US

V. Phone/Fax

Practice location:
  • Phone: 973-728-5800
  • Fax: 973-728-7070
Mailing address:
  • Phone: 973-728-5800
  • Fax: 973-728-7070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI01445600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number28RI01445600
License Number StateNJ

VIII. Authorized Official

Name: PAUL R RASA
Title or Position: PRESIDENT
Credential: RPH CCP
Phone: 973-728-5800