Provider Demographics
NPI:1114113834
Name:LUIZZI, LEONARD ANGELO JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:ANGELO
Last Name:LUIZZI
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 MEDFORD BLVD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3338
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:533 ATLANTIC CITY BLVD
Practice Address - Street 2:C/O QUICK CHEK PHARMACY
Practice Address - City:BEACHWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08722-4005
Practice Address - Country:US
Practice Address - Phone:732-349-6116
Practice Address - Fax:732-286-0058
Is Sole Proprietor?:No
Enumeration Date:2007-09-16
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02255700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ284447OtherNABP E-PROFILE
NJ28RJ01140OtherIMMUNIZATION APPROVAL