Provider Demographics
NPI:1689941361
Name:PADLO, KAREN GOTT (RPH)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:GOTT
Last Name:PADLO
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 1:900 CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-3221
Mailing Address - Country:US
Mailing Address - Phone:302-894-0250
Mailing Address - Fax:
Practice Address - Street 1:900 CENTER BLVD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-3221
Practice Address - Country:US
Practice Address - Phone:302-894-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02271600183500000X
DEA1-0002553183500000X
NJ28RJ03130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist