Provider Demographics
NPI:1003330598
Name:ALRUBAEE, MARWAN (RPH)
Entity Type:Individual
Prefix:
First Name:MARWAN
Middle Name:
Last Name:ALRUBAEE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 COUNTY AVE APT 2A
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-2732
Mailing Address - Country:US
Mailing Address - Phone:914-602-9587
Mailing Address - Fax:
Practice Address - Street 1:1 COLUMBUS PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-8201
Practice Address - Country:US
Practice Address - Phone:212-245-0636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-27
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY57722183500000X
NY057722183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist