Provider Demographics
NPI:1609867977
Name:MISURO, ANDREW J (RPH)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:J
Last Name:MISURO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:132 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4724
Mailing Address - Country:US
Mailing Address - Phone:973-322-4591
Mailing Address - Fax:973-322-4234
Practice Address - Street 1:132 SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4724
Practice Address - Country:US
Practice Address - Phone:973-322-4591
Practice Address - Fax:973-322-4234
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ13110183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist