Provider Demographics
NPI:1437311008
Name:ALY, NABIL HASSAN (R PH)
Entity Type:Individual
Prefix:MR
First Name:NABIL
Middle Name:HASSAN
Last Name:ALY
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 MALLOW ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-1730
Mailing Address - Country:US
Mailing Address - Phone:718-801-0151
Mailing Address - Fax:718-597-0094
Practice Address - Street 1:662 MORRIS PARK AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-3503
Practice Address - Country:US
Practice Address - Phone:718-597-3380
Practice Address - Fax:718-293-0094
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043081183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist