Provider Demographics
NPI:1295330298
Name:MARTINO, DENISE M (RPH)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:M
Last Name:MARTINO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BAY WAY
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7305
Mailing Address - Country:US
Mailing Address - Phone:551-427-1044
Mailing Address - Fax:732-255-7279
Practice Address - Street 1:198 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3712
Practice Address - Country:US
Practice Address - Phone:732-901-5445
Practice Address - Fax:732-901-6298
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01690100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist