Individual
JACQUELINE DERASMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
970 ROUTE 70, BRICK, NJ 08724-3502
(732) 206-8900
Mailing address
970 ROUTE 70, BRICK, NJ 08724-3502
(732) 206-8900
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RIO3219700
NJ
Other
Enumeration date
10/17/2012
Last updated
10/17/2012
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