Provider Demographics
NPI:1558840231
Name:KERNIZAN, NALINOE (PHARMD)
Entity Type:Individual
Prefix:
First Name:NALINOE
Middle Name:
Last Name:KERNIZAN
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 1:271 GROVE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1731
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18 SPARTA RD
Practice Address - Street 2:
Practice Address - City:STANHOPE
Practice Address - State:NJ
Practice Address - Zip Code:07874-2877
Practice Address - Country:US
Practice Address - Phone:201-841-9505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28R1038017001835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care