Provider Demographics
NPI:1902192891
Name:EL-KHOURY, NAIM (RPH)
Entity Type:Individual
Prefix:
First Name:NAIM
Middle Name:
Last Name:EL-KHOURY
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 1:550 ARSENAL ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-2853
Mailing Address - Country:US
Mailing Address - Phone:617-924-5987
Mailing Address - Fax:617-924-5987
Practice Address - Street 1:550 ARSENAL ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-2853
Practice Address - Country:US
Practice Address - Phone:617-924-5987
Practice Address - Fax:617-924-5987
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist