Provider Demographics
NPI:1285960922
Name:LATCHMAN, NISHA JENNA (PHARMD,CCP)
Entity type:Individual
Prefix:DR
First Name:NISHA
Middle Name:JENNA
Last Name:LATCHMAN
Suffix:
Gender:F
Credentials:PHARMD,CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 79TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5839
Mailing Address - Country:US
Mailing Address - Phone:201-295-1118
Mailing Address - Fax:800-594-7802
Practice Address - Street 1:129 79TH ST
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-5839
Practice Address - Country:US
Practice Address - Phone:201-295-1118
Practice Address - Fax:800-594-7802
Is Sole Proprietor?:No
Enumeration Date:2009-10-31
Last Update Date:2009-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02376000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist