Provider Demographics
NPI:1104067735
Name:ABOUEMARA, EMAD (BVSC)
Entity type:Individual
Prefix:DR
First Name:EMAD
Middle Name:
Last Name:ABOUEMARA
Suffix:
Gender:M
Credentials:BVSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 VERMEER DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08879-2338
Mailing Address - Country:US
Mailing Address - Phone:973-641-0241
Mailing Address - Fax:
Practice Address - Street 1:21 VERMEER DR
Practice Address - Street 2:
Practice Address - City:SOUTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08879-2338
Practice Address - Country:US
Practice Address - Phone:973-641-0241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ29VI00551400174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian