Provider Demographics
NPI:1043560733
Name:SABARESE, VICTOR E (RPH)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:E
Last Name:SABARESE
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 1:177 WESTOVER DR
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-2224
Mailing Address - Country:US
Mailing Address - Phone:609-220-6276
Mailing Address - Fax:
Practice Address - Street 1:4004 ROUTE 130
Practice Address - Street 2:
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-2401
Practice Address - Country:US
Practice Address - Phone:856-544-9051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02788700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist