Provider Demographics
NPI:1578961371
Name:RYZOFF, JEFFREY
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:RYZOFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEDMINSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07921-2605
Mailing Address - Country:US
Mailing Address - Phone:908-234-1101
Mailing Address - Fax:908-234-1103
Practice Address - Street 1:405 MAIN ST
Practice Address - Street 2:
Practice Address - City:BEDMINSTER
Practice Address - State:NJ
Practice Address - Zip Code:07921-2605
Practice Address - Country:US
Practice Address - Phone:908-234-1101
Practice Address - Fax:908-234-1103
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01993100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist