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Individual

MR. STEPHEN IP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
406 E MADISON AVE, DUMONT, NJ 07628-2629
(201) 384-8942
Mailing address
108 JEFFERSON AVE, RIVER EDGE, NJ 07661-2105
(201) 599-0713

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
5201-0701-0125-544
NJ

Other

Enumeration date
12/02/2011
Last updated
12/02/2011
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