Healthcare Provider Details

I. General information

NPI: 1780518605
Provider Name (Legal Business Name): SHAHJADI MUNNA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1912 WHITPAIN HLS
BLUE BELL PA
19422-1367
US

IV. Provider business mailing address

1912 WHITPAIN HLS
BLUE BELL PA
19422-1367
US

V. Phone/Fax

Practice location:
  • Phone: 201-993-0629
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04105900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: