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NPI Code Detail

MEDICARE: OMAR ISMAIL PHARMD

MEDICARE:   OMAR  ISMAIL  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
1183500000XPharmacist28RI04202700NJ

General Provider Information

NPI Number : 1952073470
Entity Type Code : Individual
Provider Name (Legal Business Name) : OMAR ISMAIL PHARMD
Provider Business Mailing Address
First Line : 1225 KENNEDY BLVD APT 7E APT 7E
Second Line :
City : BAYONNE
State : NJ
Zip : 07002
Country : US
Telephone Number : 201-779-7608
Fax Number :
Provider Business Practice Location Address
First Line : 425 JACK MARTIN BLVD, BRICK TOWNSHIP, NJ 08724
Second Line :
City : BRICK
State : NJ
Zip : 08724
Country : US
Telephone Number : 732-840-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2021
Last Update Date : 10/03/2021

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Directions to “ OMAR ISMAIL PHARMD” Practice Location

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