Provider Demographics
NPI:1457945040
Name:TAPIA, DENNYS
Entity Type:Individual
Prefix:
First Name:DENNYS
Middle Name:
Last Name:TAPIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MAX DR APT 11A
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-3036
Mailing Address - Country:US
Mailing Address - Phone:201-370-4060
Mailing Address - Fax:
Practice Address - Street 1:725 STATE ROUTE 10
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-1916
Practice Address - Country:US
Practice Address - Phone:973-895-3401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04108500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist