Provider Demographics
NPI:1568217321
Name:AL SHAREQI, MAGDI EBRAHIM (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:MAGDI EBRAHIM
Middle Name:
Last Name:AL SHAREQI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-4903
Mailing Address - Country:US
Mailing Address - Phone:914-343-2744
Mailing Address - Fax:
Practice Address - Street 1:1207 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-4903
Practice Address - Country:US
Practice Address - Phone:718-409-1338
Practice Address - Fax:718-409-4684
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist