Provider Demographics
NPI:1144826785
Name:SCLAFANI, JOHN A (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:SCLAFANI
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 1:46 BLOOMFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-7911
Mailing Address - Country:US
Mailing Address - Phone:917-533-6290
Mailing Address - Fax:
Practice Address - Street 1:1907 ROUTE 27
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-3212
Practice Address - Country:US
Practice Address - Phone:732-985-1211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02504600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist