Provider Demographics
NPI:1407123227
Name:AMIN, NIRA (RPH)
Entity Type:Individual
Prefix:
First Name:NIRA
Middle Name:
Last Name:AMIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-4318
Mailing Address - Country:US
Mailing Address - Phone:973-338-8134
Mailing Address - Fax:
Practice Address - Street 1:2933 VAUXHALL RD
Practice Address - Street 2:
Practice Address - City:VAUXHALL
Practice Address - State:NJ
Practice Address - Zip Code:07088-1260
Practice Address - Country:US
Practice Address - Phone:908-378-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03375000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist