Provider Demographics
NPI:1164639605
Name:SICKLER, DAVID A (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:SICKLER
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 1:8 MAZZA DR
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1168
Mailing Address - Country:US
Mailing Address - Phone:609-645-8222
Mailing Address - Fax:609-926-2226
Practice Address - Street 1:23 BETHEL RD
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-1601
Practice Address - Country:US
Practice Address - Phone:609-927-0760
Practice Address - Fax:609-926-2226
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01746000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist