Provider Demographics
NPI:1043488646
Name:FOX, GAIL C (RPH)
Entity type:Individual
Prefix:MS
First Name:GAIL
Middle Name:C
Last Name:FOX
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:GAIL
Other - Middle Name:
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:80 NEW BRIDGE RD
Mailing Address - Street 2:PATHMARK PHARMACY
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-4112
Mailing Address - Country:US
Mailing Address - Phone:201-385-6883
Mailing Address - Fax:201-385-3594
Practice Address - Street 1:80 NEW BRIDGE RD
Practice Address - Street 2:PATHMARK PHARMACY
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-4112
Practice Address - Country:US
Practice Address - Phone:201-385-6883
Practice Address - Fax:201-385-3594
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01589400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist