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General NPI Number Information
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NPI Number | 1356668453
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Entity Type | Individual
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Provider Name | OSLYN DAVIDSON PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 04/28/2010
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Last Update Date | 04/28/2010
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Provider Practice Location Address
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Address Line | 1084 BROAD ST
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City | NEWARK
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State | NJ
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Zip | 07102-2320
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Country | US
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Telephone | 973-733-2866
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Fax | 973-733-9831
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Provider Business Mailing Address
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Address Line | 323 EASTERN PKWY
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City | NEWARK
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State | NJ
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Zip | 07106-3424
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Country | US
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Telephone | 973-399-0628
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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 | 28RI02307700
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License Number State | NJ
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