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General NPI Number Information
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NPI Number | 1467057232
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Entity Type | Individual
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Provider Name | LAURA KOTLAR PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 2440 HAMBURG TPKE
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City | WAYNE
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State | NJ
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Zip | 07470-6226
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Country | US
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Telephone | 973-839-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 253 MEADOWBROOK RD
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City | WYCKOFF
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State | NJ
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Zip | 07481-3435
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Country | US
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Telephone | 973-277-9449
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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