Provider Demographics
NPI:1881298107
Name:ASUNCION, CHRISTINE ANNE RODRIGUEZ
Entity type:Individual
Prefix:
First Name:CHRISTINE ANNE
Middle Name:RODRIGUEZ
Last Name:ASUNCION
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 1:51 S PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1954
Mailing Address - Country:US
Mailing Address - Phone:201-673-4580
Mailing Address - Fax:
Practice Address - Street 1:101 POLIFLY RD
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3209
Practice Address - Country:US
Practice Address - Phone:201-525-1149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03717900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist