Provider Demographics
NPI:1932426343
Name:MUSTO, DARRYL JOHN (RPH)
Entity Type:Individual
Prefix:MR
First Name:DARRYL
Middle Name:JOHN
Last Name:MUSTO
Suffix:
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 1:754 AMERICANA CT
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8701
Mailing Address - Country:US
Mailing Address - Phone:732-929-0959
Mailing Address - Fax:
Practice Address - Street 1:220 ROUTE 70
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1025
Practice Address - Country:US
Practice Address - Phone:732-942-9469
Practice Address - Fax:732-942-8364
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02290900183500000X
NY044041183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist