Provider Demographics
NPI:1114746039
Name:ANTONIO, CHRISTIANA (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTIANA
Middle Name:
Last Name:ANTONIO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 GLENN TER
Mailing Address - Street 2:
Mailing Address - City:FREDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-5112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1982 STATE ROUTE 57
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-3470
Practice Address - Country:US
Practice Address - Phone:908-850-3529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04402400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist