Healthcare Provider Details

I. General information

NPI: 1942818315
Provider Name (Legal Business Name): JACLYN MILANO PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2020
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 LAWRENCE RD
SPRINGFIELD NJ
07081-3121
US

IV. Provider business mailing address

50 LAWRENCE RD
SPRINGFIELD NJ
07081-3121
US

V. Phone/Fax

Practice location:
  • Phone: 908-931-9111
  • Fax:
Mailing address:
  • Phone: 908-931-9111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03155700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: