Provider Demographics
NPI:1093141996
Name:RAPS, NINA H (RPH)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:H
Last Name:RAPS
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 1:8 BUTTERNUT LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-4438
Mailing Address - Country:US
Mailing Address - Phone:732-605-0473
Mailing Address - Fax:
Practice Address - Street 1:520 CONVERY BLVD
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861
Practice Address - Country:US
Practice Address - Phone:732-826-9222
Practice Address - Fax:732-293-0177
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02560100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02560100OtherSTATE LICENSE
NJ28RJ03840OtherIMMUNIZATION STATE LICENSE