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General NPI Number Information
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NPI Number | 1124824933
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Entity Type | Individual
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Provider Name | AYA ELDESOUKY
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Gender | Female
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 981 WESTSIDE AVE
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City | JERSEY CITY
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State | NJ
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Zip | 07306-6903
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Country | US
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Telephone | 201-332-0410
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Fax |
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Provider Business Mailing Address
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Address Line | 625 SUMMIT AVE APT 7N
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City | JERSEY CITY
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State | NJ
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Zip | 07306-3729
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Country | US
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Telephone | 201-920-6483
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RJ16024
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License Number State | NJ
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