Individual
ELIZABETH H. MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
9255 KENNEDY BLVD, NORTH BERGEN, NJ 07047-5322
(201) 854-6092
Mailing address
9255 KENNEDY BLVD, NORTH BERGEN, NJ 07047-5322
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03436300
NJ
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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