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General NPI Number Information
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NPI Number | 1285934018
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Entity Type | Individual
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Provider Name | NICHOLAS MICHAEL PASTOR PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/27/2010
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Last Update Date | 10/31/2010
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Provider Practice Location Address
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Address Line | 1139 WHITE HORSE RD
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City | VOORHEES
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State | NJ
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Zip | 08043-2107
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Country | US
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Telephone | 856-566-8542
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Fax |
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Provider Business Mailing Address
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Address Line | 9 LITTLE MILL CT
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City | MANTUA
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State | NJ
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Zip | 08051-1360
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Country | US
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Telephone | 856-292-3551
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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 | 28RI03301300
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License Number State | NJ
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