Provider Demographics
NPI:1902355100
Name:HA, RAYMOND J (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:J
Last Name:HA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 ROUTE 46
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-3834
Mailing Address - Country:US
Mailing Address - Phone:973-559-7979
Mailing Address - Fax:
Practice Address - Street 1:337 ROUTE 46
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-3834
Practice Address - Country:US
Practice Address - Phone:973-559-7979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061651183500000X
NJ28RI03597400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist