Provider Demographics
NPI:1972811644
Name:METTIAS, EMEEL NAZMY (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:EMEEL
Middle Name:NAZMY
Last Name:METTIAS
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BERKSHIRE WAY
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5286
Mailing Address - Country:US
Mailing Address - Phone:732-881-6355
Mailing Address - Fax:732-432-0299
Practice Address - Street 1:3 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5037
Practice Address - Country:US
Practice Address - Phone:732-432-0999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02073000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist