Healthcare Provider Details

I. General information

NPI: 1821920067
Provider Name (Legal Business Name): BUSHARA S ALI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 MLK JR BLVD 3C (CCN)
NEWARK NJ
07102
US

IV. Provider business mailing address

503 LINDSLEY DR APT 1D 1D
MORRISTOWN NJ
07960-4453
US

V. Phone/Fax

Practice location:
  • Phone: 347-422-1052
  • Fax: 862-237-7298
Mailing address:
  • Phone: 347-422-1052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04355300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: