Individual
ELEONORA TAKHTAGANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1447 HWY 35, MIDDLETOWN, NJ 07748-2030
(732) 671-4234
Mailing address
33 CAPICA CT, LAURENCE HARBOR, NJ 08879-2911
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RT03030500
NJ
Other
Enumeration date
07/28/2010
Last updated
07/28/2010
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