Active NPI
Abdallah Zidan
- Pharmacist
- Glassboro, NJ
National Provider Identifier
1295418648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- A7-0012588
- Practice address
- 22 Derby Dr
Glassboro, NJ 08028-2060 - Phone
- (845) 453-4639
- NPI assigned
- Aug 11, 2023
- Last updated
- Aug 11, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | A7-0012588 | DE | Primary |
Addresses
Primary practice location
22 Derby Dr
Glassboro, NJ 08028-2060
Mailing address
22 Derby Dr
Glassboro, NJ 08028-2060
Phone (845) 453-4639
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A7-0012588 | DE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691712000000",
"number": "1295418648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 DERBY DR",
"city": "GLASSBORO",
"state": "NJ",
"postal_code": "080282060",
"telephone_number": "845-453-4639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 DERBY DR",
"city": "GLASSBORO",
"state": "NJ",
"postal_code": "080282060",
"telephone_number": "845-453-4639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIDAN",
"first_name": "ABDALLAH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-11",
"last_updated": "2023-08-11",
"certification_date": "2023-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "DE",
"license": "A7-0012588",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glassboro, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.