Provider Demographics
NPI:1881312288
Name:ABRAHEM, NERMEN NSHAT HELMY
Entity type:Individual
Prefix:
First Name:NERMEN
Middle Name:NSHAT HELMY
Last Name:ABRAHEM
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 1:1204 OAK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-1242
Mailing Address - Country:US
Mailing Address - Phone:818-912-2814
Mailing Address - Fax:
Practice Address - Street 1:1204 OAK CREEK RD
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-1242
Practice Address - Country:US
Practice Address - Phone:818-391-2160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85933183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist