Provider Demographics
NPI:1003133257
Name:SOLDAVIN, ARNOLD ALLEN (RPH)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:ALLEN
Last Name:SOLDAVIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 MAIN ST
Mailing Address - Street 2:BOX 2219
Mailing Address - City:BRANCHVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07826-5526
Mailing Address - Country:US
Mailing Address - Phone:973-948-3170
Mailing Address - Fax:973-948-4747
Practice Address - Street 1:19 MAIN ST
Practice Address - Street 2:BOX 2219
Practice Address - City:BRANCHVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07826-5526
Practice Address - Country:US
Practice Address - Phone:973-948-3170
Practice Address - Fax:973-948-4747
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01478400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist