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General NPI Number Information
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NPI Number | 1407481450
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Entity Type | Individual
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Provider Name | NICOLLE DAMBLY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/10/2020
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 2201 CHAPEL AVE W
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City | CHERRY HILL
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State | NJ
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Zip | 08002-2048
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Country | US
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Telephone | 569-224-3128
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Fax |
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Provider Business Mailing Address
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Address Line | 75 N BATH AVE
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City | LONG BRANCH
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State | NJ
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Zip | 07740-6317
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Country | US
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Telephone | 732-923-5248
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PS59634
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PHA.0022380
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 28RI04278000
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License Number State | NJ
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