Provider Demographics
NPI:1982215786
Name:DAMKAUSKAITE, UGNE
Entity Type:Individual
Prefix:MISS
First Name:UGNE
Middle Name:
Last Name:DAMKAUSKAITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 BROWERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2680
Mailing Address - Country:US
Mailing Address - Phone:973-774-9001
Mailing Address - Fax:973-774-9995
Practice Address - Street 1:228 BROWERTOWN RD
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07424-2680
Practice Address - Country:US
Practice Address - Phone:973-774-9001
Practice Address - Fax:973-774-9995
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04061800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist