Provider Demographics
NPI:1790028132
Name:GHARABAWY, RAFIK SR
Entity Type:Individual
Prefix:
First Name:RAFIK
Middle Name:
Last Name:GHARABAWY
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2672 KENNEDY BLVD
Mailing Address - Street 2:APT 306
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-5832
Mailing Address - Country:US
Mailing Address - Phone:551-226-2691
Mailing Address - Fax:
Practice Address - Street 1:52 RIVER DR S
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310-2787
Practice Address - Country:US
Practice Address - Phone:201-216-1166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03538000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist