Individual provider Active NPI

Ihab Nagui Daniel Awad, RPH

  • Pharmacist
  • West New York, NJ
National Provider Identifier
1174115463
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI04149400 Issued in NJ
Practice address
5706 Bergenline Ave
West New York, NJ 07093-1230
Phone
(201) 869-8054
Fax
(201) 869-6697
NPI assigned
Feb 8, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 28RI04149400 NJ Primary

Addresses

Primary practice location

5706 Bergenline Ave
West New York, NJ 07093-1230

Mailing address

5706 Bergenline Ave
West New York, NJ 07093-1230
Phone (201) 869-8054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI04149400NJMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1174115463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5706 BERGENLINE AVE",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931230",
            "telephone_number": "201-869-8054",
            "fax_number": "201-869-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5706 BERGENLINE AVE",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931230",
            "telephone_number": "201-869-8054",
            "fax_number": "201-869-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWAD",
        "first_name": "IHAB",
        "middle_name": "NAGUI DANIEL",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04149400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West New York, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.