MEDICARE: ARIJETA KABA 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	28RI04332100	NJ

General Provider Information

NPI Number	:	1316727092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIJETA KABA PHARMD

Provider Business Mailing Address
First Line	:	111 BIRCH AVE
Second Line	:
City	:	POMPTON LAKES
State	:	NJ
Zip	:	07442-2503
Country	:	US
Telephone Number	:	201-290-9997
Fax Number	:

Provider Business Practice Location Address
First Line	:	750 HAMBURG TPKE
Second Line	:
City	:	POMPTON LAKES
State	:	NJ
Zip	:	07442-1452
Country	:	US
Telephone Number	:	973-835-9900
Fax Number	:

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

Provider Enumeration Date	:	10/02/2023
Last Update Date	:	10/02/2023

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