Provider Demographics
NPI:1205015773
Name:FAHMIE, DENISE (RPH)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:FAHMIE
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 1:203 WEST 12TH ST
Mailing Address - Street 2:ST VINCENT'S OUTPATIENT PHARMACY
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10011
Mailing Address - Country:US
Mailing Address - Phone:212-604-1975
Mailing Address - Fax:
Practice Address - Street 1:203 W 12TH ST
Practice Address - Street 2:ST VINCENT'S OUTPATIENT PHARMACY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7762
Practice Address - Country:US
Practice Address - Phone:212-604-1975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049131183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3332385OtherNABP