Provider Demographics
NPI:1336421627
Name:GRUCHALA-FERREIRA, MAGDALENA A (PHARMD)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:A
Last Name:GRUCHALA-FERREIRA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 INMAN AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-1114
Mailing Address - Country:US
Mailing Address - Phone:732-396-8701
Mailing Address - Fax:732-396-1341
Practice Address - Street 1:555 INMAN AVE
Practice Address - Street 2:
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067-1114
Practice Address - Country:US
Practice Address - Phone:732-396-8701
Practice Address - Fax:732-396-1341
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03287500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist