Healthcare Provider Details

I. General information

NPI: 1528997335
Provider Name (Legal Business Name): ALAA MANSRAH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 ROUTE 306
MONSEY NY
10952-1442
US

IV. Provider business mailing address

370 ROUTE 306
MONSEY NY
10952-1442
US

V. Phone/Fax

Practice location:
  • Phone: 845-364-4170
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number073927
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: