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General NPI Number Information
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NPI Number | 1497012645
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Entity Type | Individual
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Provider Name | LEON GRAZUL JR. RPH
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Gender | Male
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 2 ROXBURY MALL STRIP SHOP RITE PHARMACY
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City | SUCCASUNNA
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State | NJ
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Zip | 07876
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Country | US
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Telephone | 973-584-4466
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Fax | 973-584-4648
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Provider Business Mailing Address
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Address Line | 7 ROCKLEDGE RD
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City | RANDOLPH
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State | NJ
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Zip | 07869-4335
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Country | US
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Telephone | 973-584-4466
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Fax | 973-584-4648
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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 | 28RI01587400
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License Number State | NJ
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