Provider Demographics
NPI:1912126277
Name:HUNTER, MARY ELLYN (RP)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELLYN
Last Name:HUNTER
Suffix:
Gender:F
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 RAMAPO VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-1624
Mailing Address - Country:US
Mailing Address - Phone:201-529-5032
Mailing Address - Fax:
Practice Address - Street 1:291 RAMAPO VALLEY RD
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430-1624
Practice Address - Country:US
Practice Address - Phone:201-529-5032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01418700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist