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General NPI Number Information
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NPI Number | 1366171837
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Entity Type | Individual
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Provider Name | MR. FOUAD FARAGALLA
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Gender | Male
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Dates
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Enumeration Date | 06/08/2022
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 764 MAIN ST
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City | PATERSON
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State | NJ
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Zip | 07503-2640
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Country | US
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Telephone | 973-278-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 198 NORMAN WAY
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City | PARAMUS
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State | NJ
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Zip | 07652-5312
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Country | US
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Telephone | 120-193-2646
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Fax |
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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 | 28RI03849000
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License Number State | NJ
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