Healthcare Provider Details

I. General information

NPI: 1801710371
Provider Name (Legal Business Name): ABDUL HANNAN TAYYAB
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4082 JANDY BLVD
NAZARETH PA
18064-8838
US

IV. Provider business mailing address

338 N 12TH ST
EASTON PA
18042-3205
US

V. Phone/Fax

Practice location:
  • Phone: 610-746-3412
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP460528
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: