Provider Demographics
NPI:1508409400
Name:GIRGIS, SELVIA F (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:SELVIA
Middle Name:F
Last Name:GIRGIS
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 KENSINGTON LN
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-8246
Mailing Address - Country:US
Mailing Address - Phone:201-234-1653
Mailing Address - Fax:
Practice Address - Street 1:460B CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2531
Practice Address - Country:US
Practice Address - Phone:973-676-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03910300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist