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General NPI Number Information
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NPI Number | 1689091472
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Entity Type | Individual
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Provider Name | HIROKI WATARAI PHARMD, MPA
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Gender | Male
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Dates
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Enumeration Date | 03/18/2014
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Last Update Date | 03/18/2014
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Provider Practice Location Address
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Address Line | 83 WOODLAND PARK DR
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City | TENAFLY
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State | NJ
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Zip | 07670-3029
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Country | US
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Telephone | 305-809-6780
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Fax |
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Provider Business Mailing Address
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Address Line | 83 WOODLAND PARK DR
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City | TENAFLY
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State | NJ
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Zip | 07670-3029
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Country | US
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Telephone | 305-809-6780
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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 | PS42552
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI03153100
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH0184
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License Number State | GU
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