Provider Demographics
NPI:1346564341
Name:AMMAN, AYSHA (PHARMD)
Entity Type:Individual
Prefix:
First Name:AYSHA
Middle Name:
Last Name:AMMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 SAPPHIRE LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-1632
Mailing Address - Country:US
Mailing Address - Phone:732-940-4128
Mailing Address - Fax:
Practice Address - Street 1:4041 HADLEY RD
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-1111
Practice Address - Country:US
Practice Address - Phone:908-222-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03265400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI03265400OtherNJ PHARMACIST LISCENSE NUMBER