Provider Demographics
NPI:1043808116
Name:RAGAB, AMGAD AHMED (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:AMGAD
Middle Name:AHMED
Last Name:RAGAB
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3075 RICHMOND TER BLDG 72
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10303-1303
Mailing Address - Country:US
Mailing Address - Phone:718-442-1078
Mailing Address - Fax:718-442-1079
Practice Address - Street 1:3075 RICHMOND TER BLDG 72
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303-1303
Practice Address - Country:US
Practice Address - Phone:718-442-1078
Practice Address - Fax:718-442-1079
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054390-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist