Provider Demographics
NPI:1386517001
Name:ANDERSON, EMMA (PHARMD)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 KIRBY AVE UNIT 903
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3170
Mailing Address - Country:US
Mailing Address - Phone:678-448-6913
Mailing Address - Fax:
Practice Address - Street 1:50 KIRBY AVE UNIT 903
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-3170
Practice Address - Country:US
Practice Address - Phone:678-448-6913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RIO4443100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist