Provider Demographics
NPI:1457634024
Name:ADENODI-MATTHEWS, TINU (RPH)
Entity Type:Individual
Prefix:
First Name:TINU
Middle Name:
Last Name:ADENODI-MATTHEWS
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 1:1408 DELSEA DR
Mailing Address - Street 2:
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-4101
Mailing Address - Country:US
Mailing Address - Phone:856-845-7863
Mailing Address - Fax:856-845-9378
Practice Address - Street 1:1408 DELSEA DR
Practice Address - Street 2:
Practice Address - City:DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-4101
Practice Address - Country:US
Practice Address - Phone:856-845-7863
Practice Address - Fax:856-845-9378
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RJ00567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist