Provider Demographics
NPI:1780447755
Name:ISSA, EREINY (RPH)
Entity type:Individual
Prefix:
First Name:EREINY
Middle Name:
Last Name:ISSA
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 1:1814 LAMBERTS MILL RD
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-4767
Mailing Address - Country:US
Mailing Address - Phone:703-826-9605
Mailing Address - Fax:
Practice Address - Street 1:561 IRVINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106-3103
Practice Address - Country:US
Practice Address - Phone:973-373-0387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04325200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist