Individual
FAYA SHABO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 COLE CT, DUMONT, NJ 07628-1007
(201) 982-1446
Mailing address
12 COLE CT, DUMONT, NJ 07628-1007
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI3920300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RI03920300
NEW JERSEY BOARD OF PHARMACY
NJ
Enumeration date
01/03/2019
Last updated
01/03/2019
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