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General NPI Number Information
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NPI Number | 1003406935
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Entity Type | Individual
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Provider Name | OMAR ALLIBHAI PHARMD, RPH
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Gender | Male
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 577 MAIN ST
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City | WALTHAM
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State | MA
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Zip | 02452-5527
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Country | US
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Telephone | 781-893-3870
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Fax | 781-899-1172
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Provider Business Mailing Address
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Address Line | 8 CRAIG RD
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City | FRAMINGHAM
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State | MA
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Zip | 01701-7664
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Country | US
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Telephone | 617-899-0097
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Fax | 781-899-1172
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH234184
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License Number State | MA
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