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General NPI Number Information
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NPI Number | 1780227132
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Entity Type | Individual
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Provider Name | MR. HISHAM A GHARIB
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Gender | Male
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Dates
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Enumeration Date | 10/17/2019
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Last Update Date | 10/17/2019
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Provider Practice Location Address
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Address Line | 215 FRANKLIN AVE
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City | NUTLEY
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State | NJ
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Zip | 07110-2708
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Country | US
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Telephone | 736-676-6779
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Fax | 973-667-6675
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Provider Business Mailing Address
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Address Line | 200 SPRINGFIELD AVE APT 5021
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-1443
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Country | US
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Telephone | 973-883-6809
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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 | 28RI03567400
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License Number State | NJ
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