Provider Demographics
NPI:1417550690
Name:WEINRICH, CAROL
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:WEINRICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2569
Mailing Address - Country:US
Mailing Address - Phone:201-280-8070
Mailing Address - Fax:
Practice Address - Street 1:29-00 BROADWAY # 4
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3912
Practice Address - Country:US
Practice Address - Phone:201-475-8311
Practice Address - Fax:201-475-1937
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02282200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist