Provider Demographics
NPI:1558646778
Name:ZAKI, ASHRAF
Entity Type:Individual
Prefix:MR
First Name:ASHRAF
Middle Name:
Last Name:ZAKI
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 1:3042 92ND LN NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-5612
Mailing Address - Country:US
Mailing Address - Phone:763-221-4247
Mailing Address - Fax:
Practice Address - Street 1:9273 LAKE DR
Practice Address - Street 2:
Practice Address - City:CIRCLE PINES
Practice Address - State:MN
Practice Address - Zip Code:55014-3764
Practice Address - Country:US
Practice Address - Phone:763-783-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist