Provider Demographics
NPI:1073164661
Name:PAGNOTTA, ASHLEY ROSE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:ROSE
Last Name:PAGNOTTA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HIDDEN VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2971
Mailing Address - Country:US
Mailing Address - Phone:732-501-2576
Mailing Address - Fax:
Practice Address - Street 1:200 LACEY RD # 2
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-1333
Practice Address - Country:US
Practice Address - Phone:732-849-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04054400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist