Provider Demographics
NPI:1902329998
Name:GHANI, MALEEHA
Entity Type:Individual
Prefix:
First Name:MALEEHA
Middle Name:
Last Name:GHANI
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 1:1145 E 35TH ST APT 5C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4214
Mailing Address - Country:US
Mailing Address - Phone:718-864-1151
Mailing Address - Fax:
Practice Address - Street 1:1815 JFK BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-2180
Practice Address - Country:US
Practice Address - Phone:201-433-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03861500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist