Provider Demographics
NPI:1770189516
Name:ALMUQDADI, ALI
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:ALMUQDADI
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 1:1 WALL ST
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1699
Mailing Address - Country:US
Mailing Address - Phone:603-425-6189
Mailing Address - Fax:
Practice Address - Street 1:1 WALL ST
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1699
Practice Address - Country:US
Practice Address - Phone:603-425-6189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH239595183500000X
NH01035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist