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General NPI Number Information
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NPI Number | 1912213646
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Entity Type | Individual
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Provider Name | LIDA E DIPALMA
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Gender | Female
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Dates
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Enumeration Date | 08/18/2010
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Last Update Date | 08/18/2010
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Provider Practice Location Address
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Address Line | 1434 S BLACK HORSE PIKE
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-9130
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Country | US
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Telephone | 856-740-9612
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Fax |
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Provider Business Mailing Address
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Address Line | 1713 MALLARD CT
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-3348
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Country | US
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Telephone | 856-863-1025
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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 | 28RI02971800
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License Number State | NJ
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