=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548575285
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CAROLYN AWAD PHARM.D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/17/2010
-----------------------------------------------------
Last Update Date | 08/17/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 471 BROADWAY
-----------------------------------------------------
City | BAYONNE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07002-3622
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-339-8181
-----------------------------------------------------
Fax | 201-339-5786
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 471 BROADWAY
-----------------------------------------------------
City | BAYONNE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07002-3622
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-339-8181
-----------------------------------------------------
Fax | 201-339-5786
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 28RI03178100
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------