Basic Information
Provider Information
NPI: 1225045545
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LINDSAY
FirstName: JANIS
MiddleName: A
NamePrefix: MRS.
NameSuffix:  
Credential: RPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 290 E 24TH ST
Address2:  
City: PATERSON
State: NJ
PostalCode: 075142204
CountryCode: US
TelephoneNumber: 9736761000
FaxNumber: 9733957157
Practice Location
Address1: 385 TREMONT AVE
Address2:  
City: EAST ORANGE
State: NJ
PostalCode: 070181023
CountryCode: US
TelephoneNumber: 9736761000
FaxNumber: 9733957157
Other Information
ProviderEnumerationDate: 08/01/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000XPS18961FLY Pharmacy Service ProvidersPharmacist 

No ID Information.


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