Individual provider · NPI-1
Wylmaan White
Pharmacy Technician · Elmwood Park, NJ
NPI number1043060742
StatusActive
Last updated in NPPESMar 25, 2024
Details
- NPI
- 1043060742
- Entity type
- Individual (NPI-1)
- Name
- Wylmaan White
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 25, 2024
- Certification date
- Mar 25, 2024
- Last updated
- Mar 25, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183700000X | Pharmacy Technician | – | – | Yes |
Practice location
100 BroadwayElmwood Park, NJ 07407-3025
Phone 201-796-0204
Mailing address
100 BroadwayElmwood Park, NJ 07407-3025
Phone 201-796-0204
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