Provider Demographics
NPI:1457883670
Name:JAMISON, DANIEL (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:JAMISON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1985 SWARTHMORE AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4554
Mailing Address - Country:US
Mailing Address - Phone:888-475-0761
Mailing Address - Fax:
Practice Address - Street 1:1985 SWARTHMORE AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4554
Practice Address - Country:US
Practice Address - Phone:888-475-0761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03742300183500000X
VA0202215464183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist