Provider Demographics
NPI:1174846117
Name:SALEM, HALA A (BSC PHARM)
Entity Type:Individual
Prefix:
First Name:HALA
Middle Name:A
Last Name:SALEM
Suffix:
Gender:F
Credentials:BSC PHARM
Other - Prefix:
Other - First Name:HALA
Other - Middle Name:A
Other - Last Name:SALEM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:1225 KENNEDY BLVD APT 8A
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-2254
Mailing Address - Country:US
Mailing Address - Phone:718-616-3708
Mailing Address - Fax:
Practice Address - Street 1:1225 KENNEDY BLVD APT 8A
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-2254
Practice Address - Country:US
Practice Address - Phone:718-616-3708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042537183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist