Provider Demographics
NPI:1316427255
Name:CERMINARO, NICOLETTE ANN (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:NICOLETTE
Middle Name:ANN
Last Name:CERMINARO
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BUFFA DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-2703
Mailing Address - Country:US
Mailing Address - Phone:732-690-8654
Mailing Address - Fax:
Practice Address - Street 1:6908 MAIN STREET
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:NJ
Practice Address - Zip Code:08873
Practice Address - Country:US
Practice Address - Phone:804-693-2160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202217108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist