Provider Demographics
NPI:1891392403
Name:ABDALLA, RAFEEK NAGEEB (RPH)
Entity Type:Individual
Prefix:
First Name:RAFEEK
Middle Name:NAGEEB
Last Name:ABDALLA
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 1:4 CINDY CT
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-1878
Mailing Address - Country:US
Mailing Address - Phone:713-252-9611
Mailing Address - Fax:
Practice Address - Street 1:2825 ROUTE 18
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3798
Practice Address - Country:US
Practice Address - Phone:732-955-0770
Practice Address - Fax:732-955-0486
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03435100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist