Individual
JAD COCAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
476 W UNION AVE, BOUND BROOK, NJ 08805-1221
(732) 805-4014
(732) 805-4018
Mailing address
1201 ELLA LN, HIGHLAND PARK, NJ 08904-3012
(732) 586-9333
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI04223900
NJ
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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