Provider Demographics
NPI:1932709722
Name:LUDWIKOWSKI, HEATHER (RPH)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:LUDWIKOWSKI
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 1:19 PAKAHAKE ST
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08204-3755
Mailing Address - Country:US
Mailing Address - Phone:609-602-7231
Mailing Address - Fax:
Practice Address - Street 1:3159 ROUTE 9 S
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:NJ
Practice Address - Zip Code:08242-1012
Practice Address - Country:US
Practice Address - Phone:609-465-4497
Practice Address - Fax:609-465-7355
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045325L183500000X
DEA1-003145183500000X
NJ28RI02850800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist