Individual
JENNY PUNNOOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
345 FRANKLIN AVE, BELLEVILLE, NJ 07109-1703
(973) 302-8703
Mailing address
258 DAVEY ST APT D, BLOOMFIELD, NJ 07003-6178
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03167900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0211036
—
NJ
Enumeration date
11/21/2011
Last updated
11/21/2011
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