Provider Demographics
NPI:1366280307
Name:HAMZEH, ROA'A MOHAMMAD
Entity type:Individual
Prefix:
First Name:ROA'A
Middle Name:MOHAMMAD
Last Name:HAMZEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2331
Mailing Address - Country:US
Mailing Address - Phone:973-773-5848
Mailing Address - Fax:
Practice Address - Street 1:1138 MAIN AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2331
Practice Address - Country:US
Practice Address - Phone:973-773-5848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04381000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist