Provider Demographics
NPI:1477173623
Name:BARHOUM, DANNY ID (RPH)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:ID
Last Name:BARHOUM
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 1:114 MCARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1927
Mailing Address - Country:US
Mailing Address - Phone:347-920-6687
Mailing Address - Fax:
Practice Address - Street 1:911 E COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2069
Practice Address - Country:US
Practice Address - Phone:732-942-9987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04073400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist