Individual
JOHN IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
561 IRVINGTON AVE, NEWARK, NJ 07106-3103
(973) 373-0387
Mailing address
899 MOUNTAIN AVE, SPRINGFIELD, NJ 07081-3455
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03132400
NJ
Other
Enumeration date
11/22/2011
Last updated
11/22/2011
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