Healthcare Provider Details

I. General information

NPI: 1639033483
Provider Name (Legal Business Name): KHALID WALID ZEIDIEH PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 ROUTE 130
DELRAN NJ
08075-1868
US

IV. Provider business mailing address

3203 CONCORD DR
CINNAMINSON NJ
08077-4013
US

V. Phone/Fax

Practice location:
  • Phone: 856-461-2152
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04469600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: