Provider Demographics
NPI:1124141577
Name:PANARELLO, GAETAN L (RPH, CCP)
Entity type:Individual
Prefix:MR
First Name:GAETAN
Middle Name:L
Last Name:PANARELLO
Suffix:
Gender:M
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 1:5340 RIVER DR
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-4202
Mailing Address - Country:US
Mailing Address - Phone:609-457-7976
Mailing Address - Fax:
Practice Address - Street 1:5340 RIVER DR
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-4202
Practice Address - Country:US
Practice Address - Phone:609-457-7976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist