Provider Demographics
NPI:1700179298
Name:PASKOSKI, LJUPCO
Entity Type:Individual
Prefix:
First Name:LJUPCO
Middle Name:
Last Name:PASKOSKI
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 1:7 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-1507
Mailing Address - Country:US
Mailing Address - Phone:973-960-7661
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 517 VILLAGE SQUARE MALL
Practice Address - Street 2:
Practice Address - City:ALLAMUCHY
Practice Address - State:NJ
Practice Address - Zip Code:07820
Practice Address - Country:US
Practice Address - Phone:973-960-7661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03411000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist