Provider Demographics
NPI:1164744967
Name:GUERRA, DAVID PETER (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:PETER
Last Name:GUERRA
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 1:217 MIDLAND AVE
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-2013
Mailing Address - Country:US
Mailing Address - Phone:973-306-9952
Mailing Address - Fax:
Practice Address - Street 1:121 ALGONQUIN PKWY
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1601
Practice Address - Country:US
Practice Address - Phone:973-503-1500
Practice Address - Fax:800-242-6714
Is Sole Proprietor?:No
Enumeration Date:2010-02-20
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02147500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist