Provider Demographics
NPI:1427372150
Name:SIMBULAN, RONALD ROMERO (RPH)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:ROMERO
Last Name:SIMBULAN
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 1:22 MSGR WOJTYCHA DR
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-4890
Mailing Address - Country:US
Mailing Address - Phone:201-432-2627
Mailing Address - Fax:
Practice Address - Street 1:22 MSGR WOJTYCHA DR
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-4890
Practice Address - Country:US
Practice Address - Phone:201-432-2627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02991500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist