Provider Demographics
NPI:1578870499
Name:WITT, PAUL STANLEY (RPH)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:STANLEY
Last Name:WITT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 BAYSHORE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CAPE MAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08204-3709
Mailing Address - Country:US
Mailing Address - Phone:609-886-4214
Mailing Address - Fax:
Practice Address - Street 1:3221 BAYSHORE RD
Practice Address - Street 2:
Practice Address - City:NORTH CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-3709
Practice Address - Country:US
Practice Address - Phone:609-886-4214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01608700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist