Provider Demographics
NPI:1891680732
Name:MAQBOOL, AMMARA
Entity type:Individual
Prefix:
First Name:AMMARA
Middle Name:
Last Name:MAQBOOL
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 1:1081 INMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1132
Mailing Address - Country:US
Mailing Address - Phone:732-734-0440
Mailing Address - Fax:833-702-0965
Practice Address - Street 1:1081 INMAN AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1132
Practice Address - Country:US
Practice Address - Phone:732-734-0440
Practice Address - Fax:833-702-0965
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS007975003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy