Healthcare Provider Details

I. General information

NPI: 1598421588
Provider Name (Legal Business Name): ATEEB AHMED RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2021
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4433 KISSENA BLVD
FLUSHING NY
11355-3055
US

IV. Provider business mailing address

2049 49TH ST
ASTORIA NY
11105-1205
US

V. Phone/Fax

Practice location:
  • Phone: 917-288-7410
  • Fax:
Mailing address:
  • Phone: 917-288-7410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number068381
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: