Provider Demographics
NPI:1366718223
Name:MASRI, REAMA
Entity type:Individual
Prefix:
First Name:REAMA
Middle Name:
Last Name:MASRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REAM
Other - Middle Name:
Other - Last Name:MASRI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4424 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-1104
Mailing Address - Country:US
Mailing Address - Phone:718-369-2803
Mailing Address - Fax:718-369-2805
Practice Address - Street 1:4424 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-1104
Practice Address - Country:US
Practice Address - Phone:718-369-2803
Practice Address - Fax:718-369-2805
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRI02843000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist