Provider Demographics
NPI:1750985685
Name:ABDEL-KADER, MONA MOHAMMAD (RPH)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:MOHAMMAD
Last Name:ABDEL-KADER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22711 OATLANDS GROVE PL
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-6732
Mailing Address - Country:US
Mailing Address - Phone:703-297-6692
Mailing Address - Fax:
Practice Address - Street 1:2525 CENTREVILLE RD
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-3157
Practice Address - Country:US
Practice Address - Phone:703-713-1533
Practice Address - Fax:703-713-1484
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-22
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012014183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist