Individual
LAURA VISCOVIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
630 MAIN ST, HACKENSACK, NJ 07601-5913
(201) 678-0569
Mailing address
630 MAIN ST, HACKENSACK, NJ 07601-5913
(201) 678-0569
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
20052422
NY
183500000X
Pharmacist
Primary
28RI02093300
NJ
Other
Enumeration date
12/01/2009
Last updated
06/15/2010
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