Provider Demographics
NPI:1689264749
Name:PAL, PAULEENA (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAULEENA
Middle Name:
Last Name:PAL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-2220
Mailing Address - Country:US
Mailing Address - Phone:201-664-1004
Mailing Address - Fax:
Practice Address - Street 1:289 BROADWAY
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-2220
Practice Address - Country:US
Practice Address - Phone:201-664-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04133800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist