Provider Demographics
NPI:1356494884
Name:AGUERO, ADALBERTO ARMANDO (RPH)
Entity Type:Individual
Prefix:
First Name:ADALBERTO
Middle Name:ARMANDO
Last Name:AGUERO
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 1:7012 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:GUTTENBERG
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-4708
Mailing Address - Country:US
Mailing Address - Phone:201-662-7949
Mailing Address - Fax:201-662-9469
Practice Address - Street 1:7012 PARK AVE
Practice Address - Street 2:
Practice Address - City:GUTTENBERG
Practice Address - State:NJ
Practice Address - Zip Code:07093-4708
Practice Address - Country:US
Practice Address - Phone:201-662-7949
Practice Address - Fax:201-662-9469
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01685800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4390105Medicaid
NJ4390105Medicaid