MEDICARE: AHMED IBRAHIM RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	064429-1	NY

General Provider Information

NPI Number	:	1033686241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMED IBRAHIM RPH

Provider Business Mailing Address
First Line	:	3908A WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-3018
Country	:	US
Telephone Number	:	718-676-5959
Fax Number	:	718-676-5899

Provider Business Practice Location Address
First Line	:	3908A WHITE PLAINS RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-3018
Country	:	US
Telephone Number	:	718-676-5959
Fax Number	:	718-676-5899

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2018
Last Update Date	:	10/25/2018

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