=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184442774
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YOMNA HISHAM ABDELGHFFAR
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2024
-----------------------------------------------------
Last Update Date | 10/01/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 750 AVE AMERICAS
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10010-2716
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-336-8388
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4323 40TH ST
-----------------------------------------------------
City | SUNNYSIDE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11104-3853
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-462-6630
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 071661
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------