Provider Demographics
NPI:1073671079
Name:FALTAS, NOHA ISHAK (RPH)
Entity Type:Individual
Prefix:
First Name:NOHA
Middle Name:ISHAK
Last Name:FALTAS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 RYDERS LN
Mailing Address - Street 2:
Mailing Address - City:MILLTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08850-1706
Mailing Address - Country:US
Mailing Address - Phone:732-812-0000
Mailing Address - Fax:732-355-7000
Practice Address - Street 1:8 PARK KNOLL DR
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5280
Practice Address - Country:US
Practice Address - Phone:732-254-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist