Provider Demographics
NPI:1497379853
Name:KANDAS, NAKIA (RPH)
Entity Type:Individual
Prefix:
First Name:NAKIA
Middle Name:
Last Name:KANDAS
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 1:612 SEMINOLE DR
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-4641
Mailing Address - Country:US
Mailing Address - Phone:732-824-3705
Mailing Address - Fax:
Practice Address - Street 1:612 SEMINOLE DR
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-4641
Practice Address - Country:US
Practice Address - Phone:732-824-3705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03108100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty