Provider Demographics
NPI:1881290799
Name:ASHBAHIAN, ADRIENNE TAMAR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:TAMAR
Last Name:ASHBAHIAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1132
Mailing Address - Country:US
Mailing Address - Phone:551-427-8401
Mailing Address - Fax:
Practice Address - Street 1:425 OLD HOOK RD
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1323
Practice Address - Country:US
Practice Address - Phone:201-262-1722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03496600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist