Provider Demographics
NPI:1982942108
Name:CIGNA, KIMBERLY ROSELLA (RPH)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ROSELLA
Last Name:CIGNA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:CIGNA GARRETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:570 ROUTE 70
Mailing Address - Street 2:T-1153
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-4014
Mailing Address - Country:US
Mailing Address - Phone:732-262-7411
Mailing Address - Fax:732-746-4420
Practice Address - Street 1:570 ROUTE 70
Practice Address - Street 2:T-1153
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4014
Practice Address - Country:US
Practice Address - Phone:732-262-7411
Practice Address - Fax:732-746-4420
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRI02634300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist