Provider Demographics
NPI:1003330002
Name:SHUSTERMAN, EMMA (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:SHUSTERMAN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18-35 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-1244
Mailing Address - Country:US
Mailing Address - Phone:201-791-0012
Mailing Address - Fax:
Practice Address - Street 1:18-35 RIVER RD
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-1244
Practice Address - Country:US
Practice Address - Phone:201-791-0012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RJ01571183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist