Healthcare Provider Details

I. General information

NPI: 1750527180
Provider Name (Legal Business Name): RAGAA NOUH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2009
Last Update Date: 01/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 E 14TH ST
NEW YORK NY
10009-3336
US

IV. Provider business mailing address

529 WEST AVE
SEWAREN NJ
07077-1222
US

V. Phone/Fax

Practice location:
  • Phone: 212-979-2256
  • Fax: 212-979-0747
Mailing address:
  • Phone: 805-302-7728
  • Fax: 212-979-0747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number050744
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: