Provider Demographics
NPI:1639451123
Name:YOANIDES, JILL PAULINE (RPH)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:PAULINE
Last Name:YOANIDES
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 1:82 ELM ST
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-3221
Mailing Address - Country:US
Mailing Address - Phone:201-384-9407
Mailing Address - Fax:
Practice Address - Street 1:383 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:NJ
Practice Address - Zip Code:07642-2735
Practice Address - Country:US
Practice Address - Phone:201-664-4250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02217700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist