Healthcare Provider Details

I. General information

NPI: 1275468167
Provider Name (Legal Business Name): HOSSAMELDIN GHANEM RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 PRINCE LN
STATEN ISLAND NY
10309-4312
US

IV. Provider business mailing address

32 PRINCE LN
STATEN ISLAND NY
10309-4312
US

V. Phone/Fax

Practice location:
  • Phone: 347-967-7252
  • Fax:
Mailing address:
  • Phone: 347-982-5769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number072772
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: