Provider Demographics
NPI:1235745910
Name:LENTZ, TAYLOR (RPH)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:LENTZ
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 1:4500 LOWER MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938-9449
Mailing Address - Country:US
Mailing Address - Phone:267-825-5749
Mailing Address - Fax:
Practice Address - Street 1:23 LEVITT PKWY
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1436
Practice Address - Country:US
Practice Address - Phone:609-871-1310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI041146001835P0018X
PARP4549311835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist