Healthcare Provider Details

I. General information

NPI: 1356973028
Provider Name (Legal Business Name): SEEMA R JAMAL RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2020
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PARKWAY AVE STE A2
EWING NJ
08628-3021
US

IV. Provider business mailing address

1400 PARKWAY AVE STE A2
EWING NJ
08628-3021
US

V. Phone/Fax

Practice location:
  • Phone: 609-323-7503
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02445300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: