Provider Demographics
NPI:1013901685
Name:MARINI, RICHARD A (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:A
Last Name:MARINI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 MONTVALE AVE
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1407
Mailing Address - Country:US
Mailing Address - Phone:201-930-8553
Mailing Address - Fax:973-325-4699
Practice Address - Street 1:75 MONTVALE AVE
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-1407
Practice Address - Country:US
Practice Address - Phone:201-930-8553
Practice Address - Fax:973-325-4699
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ16162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist