Provider Demographics
NPI:1255600466
Name:JABER, AYMEN HISHAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AYMEN
Middle Name:HISHAM
Last Name:JABER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2819 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-4168
Mailing Address - Country:US
Mailing Address - Phone:718-940-3461
Mailing Address - Fax:
Practice Address - Street 1:2819 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-4168
Practice Address - Country:US
Practice Address - Phone:718-940-3461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-16
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056347183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist