Provider Demographics
NPI:1477536159
Name:NEGM, AHMED MAHMOUD (RP)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:MAHMOUD
Last Name:NEGM
Suffix:
Gender:M
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 KNICKERBOCKER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-3103
Mailing Address - Country:US
Mailing Address - Phone:718-456-5475
Mailing Address - Fax:
Practice Address - Street 1:291 KNICKERBOCKER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-3103
Practice Address - Country:US
Practice Address - Phone:718-456-5475
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist