Provider Demographics
NPI:1922755784
Name:CHARLES-CACHO, TAMISHA Z (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAMISHA
Middle Name:Z
Last Name:CHARLES-CACHO
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 1:288 THOMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-3843
Mailing Address - Country:US
Mailing Address - Phone:201-816-0507
Mailing Address - Fax:
Practice Address - Street 1:639 E 18TH ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-2184
Practice Address - Country:US
Practice Address - Phone:973-925-8885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04125700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist