Provider Demographics
NPI:1306432240
Name:MAKAR, ROGER (RPH)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:
Last Name:MAKAR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ROUTE 36
Mailing Address - Street 2:
Mailing Address - City:KEYPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07735
Mailing Address - Country:US
Mailing Address - Phone:732-598-6901
Mailing Address - Fax:
Practice Address - Street 1:100 ROUTE 36
Practice Address - Street 2:
Practice Address - City:KEYPORT
Practice Address - State:NJ
Practice Address - Zip Code:07735-1454
Practice Address - Country:US
Practice Address - Phone:732-335-4281
Practice Address - Fax:732-335-4292
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01876100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist