Provider Demographics
NPI:1518291087
Name:ABALLA, CHIDIEBERE BETRAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHIDIEBERE
Middle Name:BETRAN
Last Name:ABALLA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 EAST TREMONT AVE.
Mailing Address - Street 2:BEST AID PHARMACY
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457
Mailing Address - Country:US
Mailing Address - Phone:718-466-4700
Mailing Address - Fax:
Practice Address - Street 1:563 EAST . TREMONT AVE.
Practice Address - Street 2:BEST AID PHARMACY
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10450
Practice Address - Country:US
Practice Address - Phone:718-466-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0525381835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist