Provider Demographics
NPI:1245353051
Name:BLISS, ROBERT MORRIS (ROBERT BLISS)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MORRIS
Last Name:BLISS
Suffix:
Gender:M
Credentials:ROBERT BLISS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 PENNINGTON CT
Mailing Address - Street 2:
Mailing Address - City:DELANCO
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-5225
Mailing Address - Country:US
Mailing Address - Phone:856-764-7308
Mailing Address - Fax:856-764-7308
Practice Address - Street 1:81 PENNINGTON CT
Practice Address - Street 2:
Practice Address - City:DELANCO
Practice Address - State:NJ
Practice Address - Zip Code:08075-5225
Practice Address - Country:US
Practice Address - Phone:856-764-7308
Practice Address - Fax:856-764-7308
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28R101233300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist