Provider Demographics
NPI:1689297459
Name:ALRABABAH, ISLAM
Entity type:Individual
Prefix:DR
First Name:ISLAM
Middle Name:
Last Name:ALRABABAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 LONDON CT
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-3487
Mailing Address - Country:US
Mailing Address - Phone:262-412-8488
Mailing Address - Fax:
Practice Address - Street 1:141 LONDON CT
Practice Address - Street 2:
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-3487
Practice Address - Country:US
Practice Address - Phone:262-412-8488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHPHCY-00982183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist