Provider Demographics
NPI:1710693270
Name:UNION, RIFKA (RPH)
Entity Type:Individual
Prefix:
First Name:RIFKA
Middle Name:
Last Name:UNION
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 1:1636 CRAIG RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2786
Mailing Address - Country:US
Mailing Address - Phone:917-246-0265
Mailing Address - Fax:
Practice Address - Street 1:MADISON AVENUE PHARMACY
Practice Address - Street 2:400 MADISON AVENUE
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-0870
Practice Address - Country:US
Practice Address - Phone:732-370-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04148400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist