Provider Demographics
NPI:1104414952
Name:HAMMOUDA, NORHAN
Entity type:Individual
Prefix:
First Name:NORHAN
Middle Name:
Last Name:HAMMOUDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-7404
Mailing Address - Country:US
Mailing Address - Phone:973-396-8918
Mailing Address - Fax:973-396-8919
Practice Address - Street 1:38 MARKET ST
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-7404
Practice Address - Country:US
Practice Address - Phone:973-396-8918
Practice Address - Fax:973-396-8919
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04093100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist