Moghaddasi, Michael

Moghaddasi, Michael is an individual health care provider with primary practice located at 73 Broadway , Elmwood Park NJ 07407-3007. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Moghaddasi, Michael can be contacted via phone (201) 796-0400.

Contact Information

Primary practice address
73 Broadway Elmwood Park NJ 07407-3007
Phone: (201) 796-0400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 28RI02479100 New Jersey

Profile Details

NPI number 1912058819
LBN Legal business name Moghaddasi, Michael
Credentials PHARMD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated May 10th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912058819 NPPES
New Jersey MEDICAID 0133841

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