Individual
MR. GARY KEITH KACZKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH, CCP
Contact information
Practice address
1 NEPOTE PL, SOMERSET, NJ 08873-3478
(732) 208-0415
(732) 873-0465
Mailing address
1 NEPOTE PL, SOMERSET, NJ 08873-3478
(732) 208-0415
(732) 873-0465
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI01937000
NJ
1835G0303X
Geriatric Pharmacist
—
NJ
Other
Enumeration date
03/09/2007
Last updated
07/21/2022
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