Provider Demographics
NPI:1043816127
Name:DIEP, WAYNE B (PHARMD)
Entity type:Individual
Prefix:
First Name:WAYNE
Middle Name:B
Last Name:DIEP
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 ABBINGTON DR
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-5401
Mailing Address - Country:US
Mailing Address - Phone:609-426-2903
Mailing Address - Fax:609-426-2908
Practice Address - Street 1:629 ABBINGTON DR
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-5401
Practice Address - Country:US
Practice Address - Phone:609-426-2903
Practice Address - Fax:609-426-2908
Is Sole Proprietor?:No
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02933700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist