Healthcare Provider Details

I. General information

NPI: 1972109676
Provider Name (Legal Business Name): FRANCESCA DIBIASE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 12/08/2020
Certification Date: 12/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 PIERCE ST
SOMERSET NJ
08873-4185
US

IV. Provider business mailing address

19 CHESAPEAKE RD
MANALAPAN NJ
07726-3507
US

V. Phone/Fax

Practice location:
  • Phone: 888-319-1818
  • Fax:
Mailing address:
  • Phone: 732-710-6855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03960900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: