Provider Demographics
NPI:1831451418
Name:AFFIGATO, ANTHONY (RPH)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:AFFIGATO
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 1:2110 RT 130
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08010-3103
Mailing Address - Country:US
Mailing Address - Phone:609-871-1550
Mailing Address - Fax:609-877-7719
Practice Address - Street 1:2110 RTE 130
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:NJ
Practice Address - Zip Code:08010-3103
Practice Address - Country:US
Practice Address - Phone:609-871-1550
Practice Address - Fax:609-877-7719
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01555400183500000X
PARP035037R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist