Individual
DEMIANA IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
77-105 BLOOMFIELD AVE, BLOOMFIELD, NJ 07003-5985
(973) 259-9290
Mailing address
711 NORTH LN, APT #B10, BAYONNE, NJ 07002-1226
(347) 636-6520
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03845400
NJ
Other
Enumeration date
01/31/2017
Last updated
01/31/2017
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