Provider Demographics
NPI:1679063564
Name:SAAD, KEROLOS (RPH)
Entity type:Individual
Prefix:MR
First Name:KEROLOS
Middle Name:
Last Name:SAAD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 LANES MILL RD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-1483
Mailing Address - Country:US
Mailing Address - Phone:732-840-1800
Mailing Address - Fax:
Practice Address - Street 1:1820 LANES MILL RD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-1483
Practice Address - Country:US
Practice Address - Phone:732-840-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03933600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty