Provider Demographics
NPI:1982226999
Name:FAKHRY, NANCY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:FAKHRY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 VICTORY BLVD APT 5F
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6754
Mailing Address - Country:US
Mailing Address - Phone:646-250-0907
Mailing Address - Fax:
Practice Address - Street 1:890 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2695
Practice Address - Country:US
Practice Address - Phone:732-396-1990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066611183500000X
NJ28RI04042900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist