Healthcare Provider Details

I. General information

NPI: 1588559280
Provider Name (Legal Business Name): NICHOLAS GUZMAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 PIERCE ST
SOMERSET NJ
08873-4185
US

IV. Provider business mailing address

11 OAKWOOD DR
PARLIN NJ
08859-2105
US

V. Phone/Fax

Practice location:
  • Phone: 201-417-6470
  • Fax:
Mailing address:
  • Phone: 201-417-6470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04138200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: