Provider Demographics
NPI:1801902556
Name:ALEXANDER, MARY V (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:V
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:D
Other - Last Name:VARGHESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:708 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-1123
Mailing Address - Country:US
Mailing Address - Phone:908-253-6118
Mailing Address - Fax:908-253-6118
Practice Address - Street 1:151 KNOLLCROFT RD
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:NJ
Practice Address - Zip Code:07939-5001
Practice Address - Country:US
Practice Address - Phone:908-647-0180
Practice Address - Fax:908-604-5267
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist