Provider Demographics
NPI:1730404732
Name:DEGROOT, FRANK JOHN (RP,PD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:JOHN
Last Name:DEGROOT
Suffix:
Gender:M
Credentials:RP,PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 AUBLE RD
Mailing Address - Street 2:
Mailing Address - City:BLAIRSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07825-3010
Mailing Address - Country:US
Mailing Address - Phone:908-459-4807
Mailing Address - Fax:
Practice Address - Street 1:155 STATE ROUTE 94
Practice Address - Street 2:
Practice Address - City:BLAIRSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07825-3010
Practice Address - Country:US
Practice Address - Phone:908-459-4807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ162611835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy