Provider Demographics
NPI:1447931068
Name:VALAZZA, LINDA (RPH)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:VALAZZA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PORSCHE DR
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3515
Mailing Address - Country:US
Mailing Address - Phone:732-241-2001
Mailing Address - Fax:
Practice Address - Street 1:10 PORSCHE DR
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3515
Practice Address - Country:US
Practice Address - Phone:732-241-2001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02217200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist