Provider Demographics
NPI:1225439482
Name:HUSSAIN, RABAB
Entity Type:Individual
Prefix:
First Name:RABAB
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4196 US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852
Mailing Address - Country:US
Mailing Address - Phone:732-329-5221
Mailing Address - Fax:
Practice Address - Street 1:4196 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852-1904
Practice Address - Country:US
Practice Address - Phone:732-329-5221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03657500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist