Provider Demographics
NPI:1518399906
Name:LAOHOO, MARISSA LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:LYNN
Last Name:LAOHOO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1198 STATE ROUTE 36
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1713
Mailing Address - Country:US
Mailing Address - Phone:732-264-2881
Mailing Address - Fax:
Practice Address - Street 1:1198 STATE ROUTE 36
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1713
Practice Address - Country:US
Practice Address - Phone:732-264-2881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03570400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist