Provider Demographics
NPI:1518560614
Name:RAY, THEODORE EDWARD JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:EDWARD
Last Name:RAY
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 ROUTE 37 E
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-5562
Mailing Address - Country:US
Mailing Address - Phone:732-341-3620
Mailing Address - Fax:732-341-4863
Practice Address - Street 1:353 ROUTE 37 E
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-5562
Practice Address - Country:US
Practice Address - Phone:732-341-3620
Practice Address - Fax:732-341-4863
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03708900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist