Provider Demographics
NPI:1821380320
Name:SOK, ANDREA J
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:J
Last Name:SOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 GRAND AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605-2241
Mailing Address - Country:US
Mailing Address - Phone:646-872-7339
Mailing Address - Fax:
Practice Address - Street 1:126 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-4607
Practice Address - Country:US
Practice Address - Phone:732-594-5667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03268900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist