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General NPI Number Information
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NPI Number | 1558543652
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Entity Type | Individual
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Provider Name | PEYMAN AHDOUT RPH
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Gender | Male
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 270 PENINSULA BLVD
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City | HEMPSTEAD
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State | NY
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Zip | 11550-4913
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Country | US
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Telephone | 516-489-1942
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Fax |
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Provider Business Mailing Address
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Address Line | 17 NIRVANA AVE
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City | GREAT NECK
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State | NY
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Zip | 11023-1150
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Country | US
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Telephone | 516-829-0747
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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 | 046439
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License Number State | NY
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