Provider Demographics
NPI:1982745030
Name:MONRO, JODI ANNE (RPH, CCP)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:ANNE
Last Name:MONRO
Suffix:
Gender:F
Credentials:RPH, CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 LAKESIDE TRL
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-2842
Mailing Address - Country:US
Mailing Address - Phone:973-283-0526
Mailing Address - Fax:
Practice Address - Street 1:1141 GREENWOOD LAKE TPKE
Practice Address - Street 2:SUITE B3
Practice Address - City:RINGWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07456-1402
Practice Address - Country:US
Practice Address - Phone:973-728-5800
Practice Address - Fax:973-728-7070
Is Sole Proprietor?:No
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02038700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist