Individual
DR. HUMBERTO RAFAEL JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D., BCPS
Contact information
Practice address
111 CENTRAL AVE, PHARMACY DEPARTMENT, NEWARK, NJ 07102-1909
(973) 877-5458
Mailing address
3314 PARK AVE # 2, WEEHAWKEN, NJ 07086-5985
(201) 600-0560
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
02864900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02864900
PHARMACIST
NJ
Enumeration date
03/15/2008
Last updated
03/15/2008
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