Provider Demographics
NPI:1396860367
Name:BLISS, KAREN DIANE (RPH, CCP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:DIANE
Last Name:BLISS
Suffix:
Gender:F
Credentials:RPH, CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 BOBWHITE DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3103
Mailing Address - Country:US
Mailing Address - Phone:856-428-5762
Mailing Address - Fax:
Practice Address - Street 1:1025 BOBWHITE DR
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3103
Practice Address - Country:US
Practice Address - Phone:856-428-5762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP036396L183500000X
NJ28RI02041100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist