Provider Demographics
NPI:1861004251
Name:SZOSTAK, MAGDALENA ALICJA (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:MAGDALENA
Middle Name:ALICJA
Last Name:SZOSTAK
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PHARMACY DEPT 5987, 4296 ROUTE 130
Mailing Address - Street 2:WILLINGBORO NJ
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046
Mailing Address - Country:US
Mailing Address - Phone:609-871-9017
Mailing Address - Fax:609-871-7962
Practice Address - Street 1:PHARMACY DEPT 5987, 4296 ROUTE 130
Practice Address - Street 2:WILLINGBORO NJ
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046
Practice Address - Country:US
Practice Address - Phone:609-871-9017
Practice Address - Fax:609-871-7962
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03890200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist