Provider Demographics
NPI:1891408571
Name:NOTIS, ANGELICA P
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:P
Last Name:NOTIS
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 1:66 HALSTEAD ST
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-2033
Mailing Address - Country:US
Mailing Address - Phone:201-563-3672
Mailing Address - Fax:
Practice Address - Street 1:581 KEARNY AVE
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-2737
Practice Address - Country:US
Practice Address - Phone:201-991-3454
Practice Address - Fax:201-991-1319
Is Sole Proprietor?:No
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RJ10691183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist