Provider Demographics
NPI:1811517485
Name:BOWIE, MARLA (PHARMD, MPH)
Entity type:Individual
Prefix:DR
First Name:MARLA
Middle Name:
Last Name:BOWIE
Suffix:
Gender:F
Credentials:PHARMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 LESLIE ST
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-1204
Mailing Address - Country:US
Mailing Address - Phone:973-391-7626
Mailing Address - Fax:
Practice Address - Street 1:2536 US HIGHWAY 22 E
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-8508
Practice Address - Country:US
Practice Address - Phone:973-391-7626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03650500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RJ05699OtherNJ STATE LICENSE
NJ28RI03650500OtherNJ STATE LICENSE