MEDICARE: KHILAT ABBAS PHARMD, RPH

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	28RI04138300	NJ

General Provider Information

NPI Number	:	1669295358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHILAT ABBAS PHARMD, RPH

Provider Business Mailing Address
First Line	:	368 SIP AVE APT 1
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-6580
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	368 SIP AVE APT 1
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-6580
Country	:	US
Telephone Number	:	201-736-6314
Fax Number	:

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

Provider Enumeration Date	:	11/01/2024
Last Update Date	:	11/01/2024

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