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General NPI Number Information
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NPI Number | 1144892365
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Entity Type | Individual
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Provider Name | REBECCA ATENCIO
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Gender | Female
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Dates
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Enumeration Date | 07/15/2021
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 190 MUNSONHURST RD STE 9
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City | FRANKLIN
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State | NJ
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Zip | 07416-1810
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Country | US
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Telephone | 973-827-7340
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Fax |
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Provider Business Mailing Address
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Address Line | 1137 ROOSEVELT AVE
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City | NEW MILFORD
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State | NJ
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Zip | 07646-3226
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Country | US
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Telephone | 201-742-2305
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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 | 28RI04143800
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License Number State | NJ
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