Provider Demographics
NPI:1114249984
Name:AHMED, SAMIRA (RPH)
Entity Type:Individual
Prefix:MS
First Name:SAMIRA
Middle Name:
Last Name:AHMED
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 HOSMER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-3134
Mailing Address - Country:US
Mailing Address - Phone:917-923-0141
Mailing Address - Fax:
Practice Address - Street 1:2504 EASTCHESTER RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5902
Practice Address - Country:US
Practice Address - Phone:718-881-1578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY54342183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist