Provider Demographics
NPI:1154472488
Name:BROOK, LOREN MARGARET (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:LOREN
Middle Name:MARGARET
Last Name:BROOK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:LOREN
Other - Middle Name:MARGARET
Other - Last Name:SPARANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:23 WOODSTREAM CT
Mailing Address - Street 2:
Mailing Address - City:MANTUA
Mailing Address - State:NJ
Mailing Address - Zip Code:08051-2141
Mailing Address - Country:US
Mailing Address - Phone:856-464-6805
Mailing Address - Fax:856-464-0150
Practice Address - Street 1:4755 OGLETOWN-STANTON RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-0001
Practice Address - Country:US
Practice Address - Phone:302-733-3550
Practice Address - Fax:302-733-3572
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003516183500000X
PARP439021183500000X
NJ28RI02886800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist