Provider Demographics
NPI:1093903213
Name:BRILL, JEFFREY S (RPH)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:S
Last Name:BRILL
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 1:1000 RIVER RD
Mailing Address - Street 2:APT 2I
Mailing Address - City:BELMAR
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-2754
Mailing Address - Country:US
Mailing Address - Phone:732-280-6736
Mailing Address - Fax:
Practice Address - Street 1:1000 RIVER RD
Practice Address - Street 2:APT 2I
Practice Address - City:BELMAR
Practice Address - State:NJ
Practice Address - Zip Code:07719-2754
Practice Address - Country:US
Practice Address - Phone:732-280-6736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01805600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist