Provider Demographics
NPI:1750108296
Name:ANGELO, RHONDA ILENE
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:ILENE
Last Name:ANGELO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 E 3RD ST UNIT E
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3325
Mailing Address - Country:US
Mailing Address - Phone:856-701-9346
Mailing Address - Fax:
Practice Address - Street 1:42 E LAUREL RD STE 1900
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1357
Practice Address - Country:US
Practice Address - Phone:856-346-3535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02693200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist