Individual
ALTAF MANSURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D.
Contact information
Practice address
129 SOMERSET ST, SOMERVILLE, NJ 08876-2814
(908) 725-8259
Mailing address
4 ALTAMONT RD, EDISON, NJ 08817-4025
(732) 910-6500
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
28RI03289300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RI03289300
NJ BOARD OF PHARMACY
NJ
Enumeration date
09/22/2011
Last updated
09/22/2011
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