Provider Demographics
NPI:1275126971
Name:ALDAHONDA ELSAYED, JAIMIE LYN (PHARMACIST INTERN)
Entity Type:Individual
Prefix:
First Name:JAIMIE
Middle Name:LYN
Last Name:ALDAHONDA ELSAYED
Suffix:
Gender:F
Credentials:PHARMACIST INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 COLUMBIA AVE STE 225
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3159
Mailing Address - Country:US
Mailing Address - Phone:717-696-2655
Mailing Address - Fax:
Practice Address - Street 1:1204 MILLERSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-6677
Practice Address - Country:US
Practice Address - Phone:717-393-6074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPI-123769333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy