Provider Demographics
NPI:1508646514
Name:JOBRAN, ANMAR
Entity Type:Individual
Prefix:
First Name:ANMAR
Middle Name:
Last Name:JOBRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 WESLEY ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3023
Mailing Address - Country:US
Mailing Address - Phone:201-682-0131
Mailing Address - Fax:
Practice Address - Street 1:22 WESLEY ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3023
Practice Address - Country:US
Practice Address - Phone:201-682-0131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04326000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist