Provider Demographics
NPI:1932534310
Name:NASSER, MOHAMED (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:MOHAMED
Middle Name:
Last Name:NASSER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 79TH ST
Mailing Address - Street 2:APT. 42
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5541
Mailing Address - Country:US
Mailing Address - Phone:201-982-3780
Mailing Address - Fax:
Practice Address - Street 1:435 79TH ST
Practice Address - Street 2:APT. 42
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-5541
Practice Address - Country:US
Practice Address - Phone:201-982-3780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03582200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist