Provider Demographics
NPI:1740550763
Name:CAMACHO, MARIA VERONICA CRUZ (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARIA VERONICA
Middle Name:CRUZ
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 IROQUOIS AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE HIAWATHA
Mailing Address - State:NJ
Mailing Address - Zip Code:07034-1704
Mailing Address - Country:US
Mailing Address - Phone:973-316-5545
Mailing Address - Fax:
Practice Address - Street 1:561-579 IRVINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106
Practice Address - Country:US
Practice Address - Phone:973-373-0387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03249000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist