Provider Demographics
NPI:1508560814
Name:YOUNIS, NOORELDIN W (RPH)
Entity Type:Individual
Prefix:
First Name:NOORELDIN
Middle Name:W
Last Name:YOUNIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:NOOR
Other - Middle Name:W
Other - Last Name:YOUNIUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:410 KETTLE CREEK RD APT 6
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-1114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14 SNOWHILL ST
Practice Address - Street 2:
Practice Address - City:SPOTSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08884-1358
Practice Address - Country:US
Practice Address - Phone:732-955-6060
Practice Address - Fax:732-210-4821
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04301000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist