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General NPI Number Information
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NPI Number | 1053755629
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Entity Type | Individual
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Provider Name | DANIEL TOMAS LUGO PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2013
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Last Update Date | 04/25/2013
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Provider Practice Location Address
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Address Line | 260 US HIGHWAY 46
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City | ROCKAWAY
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State | NJ
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Zip | 07866-3854
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Country | US
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Telephone | 973-664-9412
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Fax |
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Provider Business Mailing Address
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Address Line | 32 WILLIAM ST
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City | MINE HILL
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State | NJ
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Zip | 07803-2418
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Country | US
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Telephone | 201-709-2578
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Fax |
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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 | 28RI03503600
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License Number State | NJ
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