Provider Demographics
NPI:1093010076
Name:ABDELAL, AHMED (PHARMD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:ABDELAL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3196 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3400
Mailing Address - Country:US
Mailing Address - Phone:201-675-1743
Mailing Address - Fax:
Practice Address - Street 1:12 NORTH ST # 16
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-1241
Practice Address - Country:US
Practice Address - Phone:347-598-3694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03392900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist