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General NPI Number Information
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NPI Number | 1730785932
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Entity Type | Individual
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Provider Name | AMANDA NUZZO
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Gender | Female
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Dates
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Enumeration Date | 12/11/2020
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Last Update Date | 12/11/2020
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Provider Practice Location Address
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Address Line | 281 STATE ROUTE 10 E STE 24
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City | SUCCASUNNA
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State | NJ
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Zip | 07876-1375
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Country | US
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Telephone | 973-584-4466
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Fax |
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Provider Business Mailing Address
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Address Line | 4 GIANNA CT
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City | RANDOLPH
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State | NJ
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Zip | 07869-2816
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Country | US
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Telephone | 973-670-2803
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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 | 28RI02700400
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License Number State | NJ
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