Provider Demographics
NPI:1992196760
Name:BEKHIT, GEORGE
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:BEKHIT
Suffix:
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 1:637 KENNEDY BLVD
Mailing Address - Street 2:APT #2
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-2725
Mailing Address - Country:US
Mailing Address - Phone:201-844-3685
Mailing Address - Fax:
Practice Address - Street 1:637 KENNEDY BLVD
Practice Address - Street 2:APT #2
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-2725
Practice Address - Country:US
Practice Address - Phone:201-844-3685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03689700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI03689700OtherPHARMACIST LICENCE NUMBER