Provider Demographics
NPI:1457768095
Name:CIUBINSKI, RICHARD MICHAEL JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:MICHAEL
Last Name:CIUBINSKI
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:82 TIMBERLINE RD
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-2173
Mailing Address - Country:US
Mailing Address - Phone:732-269-1161
Mailing Address - Fax:847-747-1555
Practice Address - Street 1:82 TIMBERLINE RD
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721-2173
Practice Address - Country:US
Practice Address - Phone:732-269-1161
Practice Address - Fax:847-747-1555
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02239100183500000X
PARP044431R183500000X
FLPS28029183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist