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General NPI Number Information
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NPI Number | 1780554717
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Entity Type | Individual
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Provider Name | HANAN ELIAS FADDOUL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/05/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 18 E LAUREL RD
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City | STRATFORD
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State | NJ
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Zip | 08084-1327
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Country | US
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Telephone | 407-361-7819
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Fax |
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Provider Business Mailing Address
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Address Line | 416 SPRING GARDEN ST # 419
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City | PHILADELPHIA
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State | PA
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Zip | 19123-2819
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Country | US
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Telephone | 407-361-7819
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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 | 28RI04462800
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License Number State | NJ
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