Provider Demographics
NPI:1891960225
Name:DINEEN, JEAN H (RPH, PHD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:H
Last Name:DINEEN
Suffix:
Gender:F
Credentials:RPH, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 AVENUE A
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-1273
Mailing Address - Country:US
Mailing Address - Phone:201-823-3262
Mailing Address - Fax:201-823-3483
Practice Address - Street 1:175 AVENUE A
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-1273
Practice Address - Country:US
Practice Address - Phone:201-823-3262
Practice Address - Fax:201-823-3483
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-27
Last Update Date:2008-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02164200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist