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General NPI Number Information
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NPI Number | 1497348544
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Entity Type | Individual
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Provider Name | ANITA ROBERTS PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 02/18/2021
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Last Update Date | 02/18/2021
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Provider Practice Location Address
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Address Line | 209 W RIDGEWOOD AVE # 2B
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City | PLEASANTVILLE
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State | NJ
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Zip | 08232-3739
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Country | US
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Telephone | 516-262-0072
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Fax |
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Provider Business Mailing Address
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Address Line | 25311 147TH DR
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City | ROSEDALE
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State | NY
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Zip | 11422-2823
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Country | US
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Telephone | 516-262-0072
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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