Provider Demographics
NPI:1366831042
Name:GEORGE, SHAEMA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHAEMA
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 LEHIGH AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-4081
Mailing Address - Country:US
Mailing Address - Phone:703-717-3455
Mailing Address - Fax:
Practice Address - Street 1:1199 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2552
Practice Address - Country:US
Practice Address - Phone:732-906-5794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-17
Last Update Date:2015-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03677000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist