Provider Demographics
NPI:1851993323
Name:DIAZ GARCIA, MARINETTE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARINETTE
Middle Name:
Last Name:DIAZ GARCIA
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 1:833 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-1880
Mailing Address - Country:US
Mailing Address - Phone:732-969-1441
Mailing Address - Fax:
Practice Address - Street 1:833 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:CARTERET
Practice Address - State:NJ
Practice Address - Zip Code:07008-1880
Practice Address - Country:US
Practice Address - Phone:732-969-1441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04142900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist