Provider Demographics
NPI:1811508294
Name:JOHN, SNEHA M (PHARMACIST)
Entity type:Individual
Prefix:
First Name:SNEHA
Middle Name:M
Last Name:JOHN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:768 SPRINGFIELD AVE APT E3
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-2335
Mailing Address - Country:US
Mailing Address - Phone:215-939-6901
Mailing Address - Fax:
Practice Address - Street 1:293 US HIGHWAY 206
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9548
Practice Address - Country:US
Practice Address - Phone:973-598-8913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03593000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist