Provider Demographics
NPI:1346703048
Name:HASSAN, NADEAR (RPH)
Entity Type:Individual
Prefix:
First Name:NADEAR
Middle Name:
Last Name:HASSAN
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 1:6219 RIVERSIDE STATION BLVD
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-4421
Mailing Address - Country:US
Mailing Address - Phone:201-779-8562
Mailing Address - Fax:
Practice Address - Street 1:338 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-5231
Practice Address - Country:US
Practice Address - Phone:973-759-1959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03862600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist