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NPI Code Detail

MEDICARE: WALAA KUDEH

MEDICARE:   WALAA  KUDEH
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
1183500000XPharmacist28RI04142800NJ

General Provider Information

NPI Number : 1740906791
Entity Type Code : Individual
Provider Name (Legal Business Name) : WALAA KUDEH
Provider Business Mailing Address
First Line : 1646 MAIN AVE
Second Line :
City : CLIFTON
State : NJ
Zip : 07011-2142
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1646 MAIN AVE
Second Line :
City : CLIFTON
State : NJ
Zip : 07011-2142
Country : US
Telephone Number : 973-546-9599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2022
Last Update Date : 10/12/2022

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Directions to “ WALAA KUDEH ” Practice Location

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