Provider Demographics
NPI:1508523739
Name:AYDIN, AYSE ESRA
Entity Type:Individual
Prefix:
First Name:AYSE
Middle Name:ESRA
Last Name:AYDIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 SCHLEY ST APT 225
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-2354
Mailing Address - Country:US
Mailing Address - Phone:860-938-4877
Mailing Address - Fax:
Practice Address - Street 1:801 NEWARK AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-3514
Practice Address - Country:US
Practice Address - Phone:908-820-9301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04221500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist