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General NPI Number Information
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NPI Number | 1124431630
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Entity Type | Individual
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Provider Name | BOAS PARK PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 301 N HARRISON ST
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City | PRINCETON
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State | NJ
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Zip | 08540-3512
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Country | US
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Telephone | 609-924-6125
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Fax |
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Provider Business Mailing Address
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Address Line | 73 JUNIPER WAY
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City | HAMILTON
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State | NJ
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Zip | 08619-4612
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Country | US
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Telephone | 201-983-3633
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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 | 28RI03493900
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License Number State | NJ
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