Provider Demographics
NPI:1427562016
Name:ZDANOWICZ-COOPER, KAREN (RPH)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:ZDANOWICZ-COOPER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:104 ROUTE 72
Mailing Address - Street 2:
Mailing Address - City:VINCENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08088-9680
Mailing Address - Country:US
Mailing Address - Phone:609-535-8033
Mailing Address - Fax:
Practice Address - Street 1:104 ROUTE 72
Practice Address - Street 2:
Practice Address - City:VINCENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08088-9680
Practice Address - Country:US
Practice Address - Phone:609-535-8033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-19
Last Update Date:2017-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01963600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist