Provider Demographics
NPI:1982922944
Name:RODRIGUEZ, JAVIER (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAVIER
Middle Name:
Last Name:RODRIGUEZ
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 1:10 NOLAN DR
Mailing Address - Street 2:
Mailing Address - City:MILLSTONE TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08510-9417
Mailing Address - Country:US
Mailing Address - Phone:201-222-2951
Mailing Address - Fax:
Practice Address - Street 1:994 MADISON AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-3636
Practice Address - Country:US
Practice Address - Phone:973-523-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2014-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02671800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist