Healthcare Provider Details

I. General information

NPI: 1598377863
Provider Name (Legal Business Name): AHMED HAMDY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 MT PLEASANT DR
SCRANTON PA
18503-1987
US

IV. Provider business mailing address

9978 KENNERLY RD
SAINT LOUIS MO
63128-2704
US

V. Phone/Fax

Practice location:
  • Phone: 877-520-6206
  • Fax:
Mailing address:
  • Phone: 314-843-3736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRP456890
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: