Provider Demographics
NPI:1336461136
Name:NEGM, NANCY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:NEGM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:RAGAB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:17 BARRY PL
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-2402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:909 BROAD ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-2622
Practice Address - Country:US
Practice Address - Phone:973-643-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-20
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02921100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist