Individual
EPHIGENE BANZUELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
899 MOUNTAIN AVE, SPRINGFIELD, NJ 07081-3455
(973) 376-1701
Mailing address
203 HILLSIDE AVE, BERGENFIELD, NJ 07621-2531
(201) 925-5032
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03442100
NJ
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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