Provider Demographics
NPI:1932484920
Name:CARNEVALE, CHRISTINE MARGARET (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARGARET
Last Name:CARNEVALE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:693 OAK STREET
Mailing Address - Street 2:693 OAK STREET
Mailing Address - City:RIDGEFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07657
Mailing Address - Country:US
Mailing Address - Phone:201-638-6131
Mailing Address - Fax:
Practice Address - Street 1:637 HOBOKEN ROAD
Practice Address - Street 2:WALGREENS PHARMACY DEPT.
Practice Address - City:CARLSTADT
Practice Address - State:NJ
Practice Address - Zip Code:07072
Practice Address - Country:US
Practice Address - Phone:201-842-0916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03160400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist