Provider Demographics
NPI:1972119287
Name:NAGEEB, KEROLOS N (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KEROLOS
Middle Name:N
Last Name:NAGEEB
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 EGE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1001
Mailing Address - Country:US
Mailing Address - Phone:201-844-5082
Mailing Address - Fax:
Practice Address - Street 1:440 BELLEVILLE TPKE
Practice Address - Street 2:
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-6719
Practice Address - Country:US
Practice Address - Phone:201-246-7231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04123200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist