Provider Demographics
NPI:1568827541
Name:SARNECKY, DOROTHY (RPH)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:SARNECKY
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 1:321 ROUTE 440
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-4879
Mailing Address - Country:US
Mailing Address - Phone:201-946-2535
Mailing Address - Fax:201-946-2534
Practice Address - Street 1:321 ROUTE 440
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-4879
Practice Address - Country:US
Practice Address - Phone:201-946-2535
Practice Address - Fax:201-946-2534
Is Sole Proprietor?:No
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01702100183500000X
FLPS54294183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist