Provider Demographics
NPI:1033192448
Name:ISMAIL, SALAH K (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:SALAH
Middle Name:K
Last Name:ISMAIL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2795 FRDRK DGLSS BLVD APT 7N
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-3030
Mailing Address - Country:US
Mailing Address - Phone:347-792-1545
Mailing Address - Fax:917-409-3179
Practice Address - Street 1:2632 7TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10039-2601
Practice Address - Country:US
Practice Address - Phone:917-409-3219
Practice Address - Fax:917-409-3179
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042599183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist