Provider Demographics
NPI:1912508409
Name:PLUM, DANIELLE CRISTIN (RPH)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:CRISTIN
Last Name:PLUM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PENNSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08070-9655
Mailing Address - Country:US
Mailing Address - Phone:856-935-0008
Mailing Address - Fax:856-935-0439
Practice Address - Street 1:709 S BROADWAY
Practice Address - Street 2:
Practice Address - City:PENNSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08070-9655
Practice Address - Country:US
Practice Address - Phone:856-935-0008
Practice Address - Fax:856-935-0439
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02624500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist