Healthcare Provider Details

I. General information

NPI: 1538224233
Provider Name (Legal Business Name): JACOB PETER SAEMAN R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

678 WYCKOFF AVE
WYCKOFF NJ
07481-1430
US

IV. Provider business mailing address

68 BEECHWOOD DR
WAYNE NJ
07470-5704
US

V. Phone/Fax

Practice location:
  • Phone: 201-891-3333
  • Fax: 201-891-6392
Mailing address:
  • Phone: 973-694-2682
  • Fax: 866-891-3334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRI01681200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: