Provider Demographics
NPI:1609067420
Name:AGOSTINI, CHRISTOPHER P (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:P
Last Name:AGOSTINI
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 1:251 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PENNSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08070-1200
Mailing Address - Country:US
Mailing Address - Phone:856-678-4378
Mailing Address - Fax:856-678-4421
Practice Address - Street 1:251 N BROADWAY
Practice Address - Street 2:
Practice Address - City:PENNSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08070-1200
Practice Address - Country:US
Practice Address - Phone:856-678-4378
Practice Address - Fax:856-678-4421
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02529700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist