Provider Demographics
NPI:1649552266
Name:FOUAD, MOHAMED (PHARMD/MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:
Last Name:FOUAD
Suffix:
Gender:
Credentials:PHARMD/MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 MAIN ST
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2621
Mailing Address - Country:US
Mailing Address - Phone:973-754-3032
Mailing Address - Fax:
Practice Address - Street 1:703 MAIN ST
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2621
Practice Address - Country:US
Practice Address - Phone:973-754-3032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3140460F1835P0018X, 1835P1200X
NJ61511181835P2201X
NJ28RI03425000183500000X
PARP445995183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care