Basic Information
Provider Information
NPI: 1003138934
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALTMAN
FirstName: JANINE
MiddleName: PAULINE
NamePrefix: MRS.
NameSuffix:  
Credential: RPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1133 YORK RD
Address2:  
City: WARMINSTER
State: PA
PostalCode: 189742048
CountryCode: US
TelephoneNumber: 2156743503
FaxNumber: 2156742952
Practice Location
Address1: 1133 YORK RD
Address2:  
City: WARMINSTER
State: PA
PostalCode: 189742048
CountryCode: US
TelephoneNumber: 2156743503
FaxNumber: 2156742952
Other Information
ProviderEnumerationDate: 02/19/2010
LastUpdateDate: 02/19/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000XRP038458LPAY Pharmacy Service ProvidersPharmacist 

No ID Information.


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