Provider Demographics
NPI:1437831419
Name:ALHASSANY, AHMED
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:ALHASSANY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 GODDARD DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-4412
Mailing Address - Country:US
Mailing Address - Phone:774-232-8149
Mailing Address - Fax:
Practice Address - Street 1:302 MAIN ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MA
Practice Address - Zip Code:01540-2361
Practice Address - Country:US
Practice Address - Phone:508-987-1327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH241647183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist