MEDICARE: DR. OMAR M JALUDI PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI03112900	NJ

General Provider Information

NPI Number	:	1023255213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OMAR M JALUDI PHARMD

Provider Business Mailing Address
First Line	:	7527 BERGENLINE AVE
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5459
Country	:	US
Telephone Number	:	201-590-8776
Fax Number	:

Provider Business Practice Location Address
First Line	:	7527 BERGENLINE AVE
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5459
Country	:	US
Telephone Number	:	201-590-8776
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2009
Last Update Date	:	01/10/2009

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