Provider Demographics
NPI:1104369248
Name:AMIN, ALAY J (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALAY
Middle Name:J
Last Name:AMIN
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 1:1071 ROUTE 37 W UNIT 10
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5026
Mailing Address - Country:US
Mailing Address - Phone:732-503-4111
Mailing Address - Fax:
Practice Address - Street 1:1071 ROUTE 37 W UNIT 10
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5026
Practice Address - Country:US
Practice Address - Phone:732-503-4111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03833300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist