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Individual

ANTHONY JOHN PONTERIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
41 BALMORAL DR, JACKSON, NJ 08527-4476
(732) 299-9365
Mailing address
41 BALMORAL DR, JACKSON, NJ 08527-4476
(732) 299-9365

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI01668000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
28RI01668000
NJ
Enumeration date
12/10/2020
Last updated
12/10/2020
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