MEDICARE: JANELLE TRINIDAD PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI03440300	NJ

General Provider Information

NPI Number	:	1205117793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANELLE TRINIDAD PHARMD

Provider Business Mailing Address
First Line	:	2308 HALSEY ST
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-5133
Country	:	US
Telephone Number	:	908-265-7111
Fax Number	:

Provider Business Practice Location Address
First Line	:	2148 MORRIS AVE
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-6006
Country	:	US
Telephone Number	:	908-687-4994
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2011
Last Update Date	:	08/29/2011

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Directions to “ JANELLE TRINIDAD PHARMD” Practice Location

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