Provider Demographics
NPI:1134792864
Name:ABDELJABBAR, BAHA EDDIN M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BAHA
Middle Name:EDDIN M
Last Name:ABDELJABBAR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:BAHA
Other - Middle Name:
Other - Last Name:ABDELJABBAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:699 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-4724
Mailing Address - Country:US
Mailing Address - Phone:201-424-9535
Mailing Address - Fax:
Practice Address - Street 1:699 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-4724
Practice Address - Country:US
Practice Address - Phone:201-424-9535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03094700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist