Healthcare Provider Details

I. General information

NPI: 1053249508
Provider Name (Legal Business Name): IMAD HADDAD PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 OAKLAND ST
BERKELEY HEIGHTS NJ
07922-1907
US

IV. Provider business mailing address

115 OAKLAND ST
BERKELEY HEIGHTS NJ
07922-1907
US

V. Phone/Fax

Practice location:
  • Phone: 973-432-1363
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RIO2701000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: