Individual
DR. NICOLE MANFRIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH, PHARMD
Contact information
Practice address
194 BROAD ST STE B, BLOOMFIELD, NJ 07003-4394
(973) 429-0444
(973) 429-0440
Mailing address
194 BROAD ST STE B, BLOOMFIELD, NJ 07003-4394
(973) 429-0444
(973) 429-0440
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
28RI03406300
NJ
1835P1200X
Pharmacotherapy Pharmacist
Primary
PCT.0011042
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RI03406300
STATE PHARMACIST LICENSE
NJ
01
—
PCT.0011042
STATE PHARMACIST LICENSE
CT
Enumeration date
12/17/2021
Last updated
12/17/2021
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