Provider Demographics
NPI:1871817890
Name:DENHAM, MARGUERITE ANN (RPH)
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:ANN
Last Name:DENHAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MARGUERITE
Other - Middle Name:ANN
Other - Last Name:LAGREGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:111 IVY RD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3057
Mailing Address - Country:US
Mailing Address - Phone:732-618-8899
Mailing Address - Fax:732-414-1980
Practice Address - Street 1:901 W MAIN ST
Practice Address - Street 2:AMBULATORY CAMPUS SUITE 162
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2537
Practice Address - Country:US
Practice Address - Phone:732-414-1977
Practice Address - Fax:732-414-1980
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036125-1183500000X
NJ28R103010600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist