Provider Demographics
NPI:1528293602
Name:MOUSSA, NANCY NASHAAT NAGIB (RPH)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:NASHAAT NAGIB
Last Name:MOUSSA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 COUNTRY VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-1241
Mailing Address - Country:US
Mailing Address - Phone:201-203-6455
Mailing Address - Fax:
Practice Address - Street 1:70 JACKSON DR
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3510
Practice Address - Country:US
Practice Address - Phone:908-931-9111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03181200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist