Provider Demographics
NPI:1255739397
Name:PINO, LAUREN JESSICA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:JESSICA
Last Name:PINO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:583 DEFRANCESCO CIR
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-4905
Mailing Address - Country:US
Mailing Address - Phone:856-981-0858
Mailing Address - Fax:
Practice Address - Street 1:583 DEFRANCESCO CIR
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-4905
Practice Address - Country:US
Practice Address - Phone:856-981-0858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03439900183500000X
PARP446214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist