Provider Demographics
NPI:1144589094
Name:AYOUB, AHMED M (RPH)
Entity Type:Individual
Prefix:MR
First Name:AHMED
Middle Name:M
Last Name:AYOUB
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 60TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-2219
Mailing Address - Country:US
Mailing Address - Phone:917-533-1001
Mailing Address - Fax:
Practice Address - Street 1:3317 60TH ST
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-2219
Practice Address - Country:US
Practice Address - Phone:917-533-1001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-14
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049782183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist