Healthcare Provider Details

I. General information

NPI: 1679887749
Provider Name (Legal Business Name): SHERIN ABDELMALAK RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2010
Last Update Date: 08/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 RTE 36
HAZLET NJ
07730-1716
US

IV. Provider business mailing address

3 SASHA CT
MATAWAN NJ
07747-6857
US

V. Phone/Fax

Practice location:
  • Phone: 732-264-3114
  • Fax: 732-335-3940
Mailing address:
  • Phone: 732-264-3114
  • Fax: 732-335-3940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02923700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: