Provider Demographics
NPI:1003129412
Name:CHARNEY, GERALD B
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:B
Last Name:CHARNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PLANTATION WAY
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08501-1870
Mailing Address - Country:US
Mailing Address - Phone:609-585-3925
Mailing Address - Fax:609-585-8753
Practice Address - Street 1:1801 KUSER RD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3705
Practice Address - Country:US
Practice Address - Phone:609-585-3925
Practice Address - Fax:609-585-8753
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01145600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist