Healthcare Provider Details

I. General information

NPI: 1487565099
Provider Name (Legal Business Name): NAILAH MOHIDEEN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 NEW BRUNSWICK AVE
PERTH AMBOY NJ
08861-4126
US

IV. Provider business mailing address

9 IVES CT
MONROE TOWNSHIP NJ
08831-1625
US

V. Phone/Fax

Practice location:
  • Phone: 908-257-0308
  • Fax: 908-257-0306
Mailing address:
  • Phone: 848-234-8574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04431000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: