Provider Demographics
NPI:1043766850
Name:SERPICO, JAMES (RPH, MBA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:SERPICO
Suffix:
Gender:M
Credentials:RPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 WHIPPANY AVENUE
Mailing Address - Street 2:
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-0915
Mailing Address - Country:US
Mailing Address - Phone:862-404-3833
Mailing Address - Fax:
Practice Address - Street 1:67 WHIPPANY AVENUE
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-0915
Practice Address - Country:US
Practice Address - Phone:862-404-3833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01771900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ518516OtherNABP NUMBER