MEDICARE: MR. MOHAMED NASSER PHARM.D.

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	28RI03582200	NJ

General Provider Information

NPI Number	:	1932534310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MOHAMED NASSER PHARM.D.

Provider Business Mailing Address
First Line	:	435 79TH ST
Second Line	:	APT. 42
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5541
Country	:	US
Telephone Number	:	201-982-3780
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 79TH ST
Second Line	:	APT. 42
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5541
Country	:	US
Telephone Number	:	201-982-3780
Fax Number	:

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

Provider Enumeration Date	:	09/04/2013
Last Update Date	:	09/04/2013

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