Provider Demographics
NPI:1427866821
Name:AMATULLAH, FARIHAH (PHARMD)
Entity type:Individual
Prefix:
First Name:FARIHAH
Middle Name:
Last Name:AMATULLAH
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 1:29 BRADFORD PL
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-1327
Mailing Address - Country:US
Mailing Address - Phone:732-877-6455
Mailing Address - Fax:
Practice Address - Street 1:29 BRADFORD PL
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-1327
Practice Address - Country:US
Practice Address - Phone:732-877-6455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist