Provider Demographics
NPI:1942330006
Name:MORABITO, DOMINICK (RPH REGISTERED PHARM)
Entity Type:Individual
Prefix:
First Name:DOMINICK
Middle Name:
Last Name:MORABITO
Suffix:
Gender:M
Credentials:RPH REGISTERED PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 COUNTRY CLUB LANE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208
Mailing Address - Country:US
Mailing Address - Phone:908-353-1574
Mailing Address - Fax:
Practice Address - Street 1:21 N 20TH ST
Practice Address - Street 2:
Practice Address - City:KENILWORTH
Practice Address - State:NJ
Practice Address - Zip Code:07033
Practice Address - Country:US
Practice Address - Phone:908-709-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01814300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist