Provider Demographics
NPI:1699413559
Name:FARHAT, IBRAHIM ALI (RPH)
Entity Type:Individual
Prefix:DR
First Name:IBRAHIM
Middle Name:ALI
Last Name:FARHAT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 85TH ST APT 3K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4718
Mailing Address - Country:US
Mailing Address - Phone:347-677-5795
Mailing Address - Fax:
Practice Address - Street 1:652 E 233RD ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2802
Practice Address - Country:US
Practice Address - Phone:718-696-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-21
Last Update Date:2022-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036310-01183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist