Provider Demographics
NPI:1073845707
Name:AHN, PEGGY (RPH)
Entity Type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:
Last Name:AHN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 BOBOLINK CT
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-8451
Mailing Address - Country:US
Mailing Address - Phone:201-838-5830
Mailing Address - Fax:
Practice Address - Street 1:45 ROUTE 46 STE 609
Practice Address - Street 2:
Practice Address - City:PINE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07058-9397
Practice Address - Country:US
Practice Address - Phone:973-276-7584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02339100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist