Provider Demographics
NPI:1912358235
Name:FOWLER, SACHOY (PHARMD)
Entity Type:Individual
Prefix:
First Name:SACHOY
Middle Name:
Last Name:FOWLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 CAMBRIDGE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-2027
Mailing Address - Country:US
Mailing Address - Phone:256-289-5972
Mailing Address - Fax:
Practice Address - Street 1:35 MILL RD
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1009
Practice Address - Country:US
Practice Address - Phone:973-372-0733
Practice Address - Fax:973-372-1283
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03562400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist