Provider Demographics
NPI:1629296504
Name:SPANO, KAREN B (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:B
Last Name:SPANO
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 1:102 AMERICAN RD
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-2443
Mailing Address - Country:US
Mailing Address - Phone:973-597-0444
Mailing Address - Fax:973-867-2301
Practice Address - Street 1:102 AMERICAN RD
Practice Address - Street 2:
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-2443
Practice Address - Country:US
Practice Address - Phone:973-597-0444
Practice Address - Fax:973-867-2301
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01798600183500000X
NY033957-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist