Provider Demographics
NPI:1639354012
Name:ABDRABOUH, WESAM M (RPH)
Entity Type:Individual
Prefix:MR
First Name:WESAM
Middle Name:M
Last Name:ABDRABOUH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CURLEY CT
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1632
Mailing Address - Country:US
Mailing Address - Phone:201-447-0780
Mailing Address - Fax:
Practice Address - Street 1:205 CURLEY CT
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1632
Practice Address - Country:US
Practice Address - Phone:201-447-0780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02710400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist