Provider Demographics
NPI:1790894491
Name:BARTHOLD, ARTHUR SCOT (RPH)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:SCOT
Last Name:BARTHOLD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LINCOLN PL
Mailing Address - Street 2:
Mailing Address - City:WALDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:07463-1924
Mailing Address - Country:US
Mailing Address - Phone:201-447-2175
Mailing Address - Fax:
Practice Address - Street 1:199 KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07656-1335
Practice Address - Country:US
Practice Address - Phone:201-391-3232
Practice Address - Fax:201-930-9672
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2008-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ15955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ15955OtherSTATE LISCENSE NUMBER