Healthcare Provider Details

I. General information

NPI: 1487519583
Provider Name (Legal Business Name): AHMED BASSRY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4849 MARKET ST
PHILADELPHIA PA
19139-3508
US

IV. Provider business mailing address

4849 MARKET ST
PHILADELPHIA PA
19139-3508
US

V. Phone/Fax

Practice location:
  • Phone: 215-474-4801
  • Fax:
Mailing address:
  • Phone: 215-474-4801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP460078
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: