Provider Demographics
NPI:1871808451
Name:MATSUK, JAMES A JR (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:MATSUK
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 BRIDGETON PIKE
Mailing Address - Street 2:
Mailing Address - City:MANTUA
Mailing Address - State:NJ
Mailing Address - Zip Code:08051-1915
Mailing Address - Country:US
Mailing Address - Phone:856-468-5513
Mailing Address - Fax:856-468-4629
Practice Address - Street 1:210 BRIDGETON PIKE
Practice Address - Street 2:
Practice Address - City:MANTUA
Practice Address - State:NJ
Practice Address - Zip Code:08051-1915
Practice Address - Country:US
Practice Address - Phone:856-468-5513
Practice Address - Fax:856-468-4629
Is Sole Proprietor?:No
Enumeration Date:2010-08-08
Last Update Date:2010-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01463100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist