MEDICARE: RANA FERDOUS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RJ06889	NJ

General Provider Information

NPI Number	:	1336810662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANA FERDOUS

Provider Business Mailing Address
First Line	:	572 PATERSON AVE
Second Line	:
City	:	EAST RUTHERFORD
State	:	NJ
Zip	:	07073-1106
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	572 PATERSON AVE
Second Line	:
City	:	EAST RUTHERFORD
State	:	NJ
Zip	:	07073-1106
Country	:	US
Telephone Number	:	201-507-3602
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2021
Last Update Date	:	09/27/2021

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Directions to “ RANA FERDOUS ” Practice Location

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