Provider Demographics
NPI:1033431895
Name:RODMAN, KERRI KATHLEEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:KATHLEEN
Last Name:RODMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:KATHLEEN
Other - Last Name:TUOHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:2325 ROUTE 516
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-1893
Mailing Address - Country:US
Mailing Address - Phone:732-952-3280
Mailing Address - Fax:
Practice Address - Street 1:2325 ROUTE 516
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-1893
Practice Address - Country:US
Practice Address - Phone:732-952-3280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049766183500000X
NJ28RI03372600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist