Provider Demographics
NPI:1972875425
Name:KAUFMAN, JACQUELINE MELE (RPH)
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:MELE
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 GREENWICH ST
Mailing Address - Street 2:ZACK'S PHARMACY
Mailing Address - City:BELVIDERE
Mailing Address - State:NJ
Mailing Address - Zip Code:07823-1449
Mailing Address - Country:US
Mailing Address - Phone:908-475-1060
Mailing Address - Fax:908-475-1130
Practice Address - Street 1:15 GREENWICH ST
Practice Address - Street 2:ZACK'S PHARMACY
Practice Address - City:BELVIDERE
Practice Address - State:NJ
Practice Address - Zip Code:07823-1449
Practice Address - Country:US
Practice Address - Phone:908-475-1060
Practice Address - Fax:908-475-1130
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02090300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist