Provider Demographics
NPI:1588984108
Name:MESSIHA, HOSSAM H (RPH)
Entity type:Individual
Prefix:
First Name:HOSSAM
Middle Name:H
Last Name:MESSIHA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:WEST DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08086-2216
Mailing Address - Country:US
Mailing Address - Phone:856-853-2943
Mailing Address - Fax:
Practice Address - Street 1:1000 KINGS HWY
Practice Address - Street 2:
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08086-2216
Practice Address - Country:US
Practice Address - Phone:856-853-2943
Practice Address - Fax:856-853-2947
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03112600183500000X
PARP444434183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist