Provider Demographics
NPI:1255517934
Name:TOMLIN, CANDICE MARIE (CPHT)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:MARIE
Last Name:TOMLIN
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-2142
Mailing Address - Country:US
Mailing Address - Phone:888-858-6175
Mailing Address - Fax:888-858-6176
Practice Address - Street 1:149 3RD AVE
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-2142
Practice Address - Country:US
Practice Address - Phone:888-858-6175
Practice Address - Fax:888-858-6176
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-13
Last Update Date:2008-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician