Provider Demographics
NPI:1043435456
Name:LOSASSO, HELEN M (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:HELEN
Middle Name:M
Last Name:LOSASSO
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 PARKVILLE STATION RD
Mailing Address - Street 2:
Mailing Address - City:MANTUA
Mailing Address - State:NJ
Mailing Address - Zip Code:08051-1621
Mailing Address - Country:US
Mailing Address - Phone:609-502-4398
Mailing Address - Fax:
Practice Address - Street 1:304 PARKVILLE STATION RD
Practice Address - Street 2:
Practice Address - City:MANTUA
Practice Address - State:NJ
Practice Address - Zip Code:08051-1621
Practice Address - Country:US
Practice Address - Phone:609-502-4398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2012-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01773900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist