Provider Demographics
NPI:1477568020
Name:BRICKMAN, LORETTA (RPH)
Entity Type:Individual
Prefix:MS
First Name:LORETTA
Middle Name:
Last Name:BRICKMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 STONEHENGE DR
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-2050
Mailing Address - Country:US
Mailing Address - Phone:908-454-5099
Mailing Address - Fax:908-859-2952
Practice Address - Street 1:206 STONEHENGE DR
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2050
Practice Address - Country:US
Practice Address - Phone:908-454-5099
Practice Address - Fax:908-859-2952
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01213100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist