Provider Demographics
NPI:1619304730
Name:BADAWY, IMAN M (PHARMD)
Entity Type:Individual
Prefix:
First Name:IMAN
Middle Name:M
Last Name:BADAWY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MACARTHUR BLVD
Mailing Address - Street 2:APT # N913
Mailing Address - City:HADDON TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-3648
Mailing Address - Country:US
Mailing Address - Phone:320-444-2972
Mailing Address - Fax:
Practice Address - Street 1:3046 NEW JERSEY 38
Practice Address - Street 2:WALGREENS
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054
Practice Address - Country:US
Practice Address - Phone:609-747-9635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03567500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist