Healthcare Provider Details

I. General information

NPI: 1023432077
Provider Name (Legal Business Name): MARIA YANOSCHAK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2014
Last Update Date: 05/18/2020
Certification Date: 05/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 SOUTH AVE W
WESTFIELD NJ
07090-1418
US

IV. Provider business mailing address

1115 SOUTH AVE W
WESTFIELD NJ
07090-1418
US

V. Phone/Fax

Practice location:
  • Phone: 908-233-2200
  • Fax: 908-233-3975
Mailing address:
  • Phone: 908-233-2200
  • Fax: 908-233-3975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH031311955-1
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03512300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: