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Individual

EVAN REINECKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
425 ANDERSON AVE, FAIRVIEW, NJ 07022-1103
(201) 941-7170
Mailing address
35-07 GARDEN VIEW TER, FAIR LAWN, NJ 07410-4338
(201) 794-1293

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI02604600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
28RI02604600
PHARMACY
NJ
Enumeration date
02/20/2008
Last updated
02/20/2008
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