Individual
DR. ALAN ALEXANDER OUSTAEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D.
Contact information
Practice address
60 ESSEX ST STE 105, ROCHELLE PARK, NJ 07662-4347
(201) 880-7000
Mailing address
9707 63RD RD APT 3E, REGO PARK, NY 11374-1610
(917) 435-9792
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03942700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RI03942700
NEW JERSEY BOARD OF PHARMACY LICENSE
NJ
Enumeration date
07/26/2018
Last updated
07/26/2018
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