Provider Demographics
NPI:1316724388
Name:KWAIK, NOUR A (PHARMD)
Entity type:Individual
Prefix:
First Name:NOUR
Middle Name:A
Last Name:KWAIK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 APPLE LN
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-1964
Mailing Address - Country:US
Mailing Address - Phone:973-641-7794
Mailing Address - Fax:
Practice Address - Street 1:156 NEWARK POMPTON TPKE
Practice Address - Street 2:
Practice Address - City:PEQUANNOCK
Practice Address - State:NJ
Practice Address - Zip Code:07440-1327
Practice Address - Country:US
Practice Address - Phone:973-692-1221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04324800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist