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General NPI Number Information
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NPI Number | 1003907569
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Entity Type | Individual
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Provider Name | CARLOS M MARIN RPH
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Gender | Male
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 45 KULICK RD
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City | FAIRFIELD
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State | NJ
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Zip | 07004-3307
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Country | US
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Telephone | 973-575-0614
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Fax | 973-575-4580
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Provider Business Mailing Address
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Address Line | 10 WESTOVER TER
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City | WEST CALDWELL
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State | NJ
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Zip | 07006-7722
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Country | US
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Telephone | 973-403-0263
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Fax | 973-226-6796
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI01791500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1835N1003X
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Taxonomy Name | Nutrition Support Pharmacist
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License Number | 28RI01791500
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License Number State | NJ
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