Individual
KAYLA MARIE ROQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
794 MOUNT PROSPECT AVE, NEWARK, NJ 07104-3221
(973) 483-4749
Mailing address
751 DEGRAW AVE, NEWARK, NJ 07104-1617
(862) 596-4840
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI04188900
NJ
Other
Enumeration date
09/19/2021
Last updated
09/19/2021
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