Individual
MRS. KATHERINE ILIADIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
219 E MAIN ST, MOORESTOWN, NJ 08057-2905
(856) 914-2021
Mailing address
40 BROOKS RD, MOORESTOWN, NJ 08057-3858
(856) 722-9351
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI02085900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RI02085900
PROFESSIONAL LICENSE
NJ
Enumeration date
03/06/2021
Last updated
03/06/2021
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