Provider Demographics
NPI:1003120585
Name:ESA, AHMED A (PHARMD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:A
Last Name:ESA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 W 173RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1635
Mailing Address - Country:US
Mailing Address - Phone:646-692-4646
Mailing Address - Fax:646-692-4645
Practice Address - Street 1:572 W 173RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1635
Practice Address - Country:US
Practice Address - Phone:646-692-4646
Practice Address - Fax:646-692-4645
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054677183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist