Provider Demographics
NPI:1720676281
Name:UGUR, OMER
Entity Type:Individual
Prefix:
First Name:OMER
Middle Name:
Last Name:UGUR
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 1:828 N OLDEN AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-4902
Mailing Address - Country:US
Mailing Address - Phone:908-313-8133
Mailing Address - Fax:
Practice Address - Street 1:828 N OLDEN AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-4902
Practice Address - Country:US
Practice Address - Phone:908-313-8133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RW01228100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist