Provider Demographics
NPI:1316251374
Name:NAKHLA, NABIL H
Entity type:Individual
Prefix:MR
First Name:NABIL
Middle Name:H
Last Name:NAKHLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 FERRY ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-2113
Mailing Address - Country:US
Mailing Address - Phone:973-344-2982
Mailing Address - Fax:973-344-4630
Practice Address - Street 1:140 FERRY ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-2113
Practice Address - Country:US
Practice Address - Phone:973-344-2982
Practice Address - Fax:973-344-4630
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI025410001835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy