Provider Demographics
NPI:1679673032
Name:MAUNTEL, CHERIE-ANNE (RPH)
Entity Type:Individual
Prefix:
First Name:CHERIE-ANNE
Middle Name:
Last Name:MAUNTEL
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:PSC 103 BOX 1028
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09603
Mailing Address - Country:IT
Mailing Address - Phone:01139043-430-5333
Mailing Address - Fax:
Practice Address - Street 1:31 MEDICAL GROUP
Practice Address - Street 2:UNIT 6180, BOX 245
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09604
Practice Address - Country:IT
Practice Address - Phone:011043-430-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02347700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist