Provider Demographics
NPI:1972827855
Name:OLIVEIRA, BRIAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:OLIVEIRA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38-42 MAIN ST
Mailing Address - Street 2:BAKER'S PHARMACY
Mailing Address - City:SUSSEX
Mailing Address - State:NJ
Mailing Address - Zip Code:07461-2331
Mailing Address - Country:US
Mailing Address - Phone:973-875-4141
Mailing Address - Fax:
Practice Address - Street 1:38-42 MAIN ST
Practice Address - Street 2:BAKER'S PHARMACY
Practice Address - City:SUSSEX
Practice Address - State:NJ
Practice Address - Zip Code:07461-2331
Practice Address - Country:US
Practice Address - Phone:973-875-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-21
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03291400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist