Provider Demographics
NPI:1780287359
Name:FINE, LYNNE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:
Last Name:FINE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:LYNNE
Other - Middle Name:
Other - Last Name:FINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:230 MILLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2553
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2553
Practice Address - Country:US
Practice Address - Phone:908-231-6360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02767900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02767900OtherNJ PHARMACIST LICENSE