Provider Demographics
NPI:1912280322
Name:AL-MILLI, RANIA M
Entity Type:Individual
Prefix:
First Name:RANIA
Middle Name:M
Last Name:AL-MILLI
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 1:279 BROWERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2663
Mailing Address - Country:US
Mailing Address - Phone:973-837-8830
Mailing Address - Fax:973-837-8831
Practice Address - Street 1:279 BROWERTOWN RD
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07424-2663
Practice Address - Country:US
Practice Address - Phone:973-837-8830
Practice Address - Fax:973-837-8831
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03028300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1750523726OtherWALGREENS PHARMACY