Provider Demographics
NPI:1942905104
Name:ELDESSOUKI, AHMED (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:
Last Name:ELDESSOUKI
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 1:4 LANDMARK LN
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-2440
Mailing Address - Country:US
Mailing Address - Phone:732-513-4450
Mailing Address - Fax:
Practice Address - Street 1:3 SANDY LN
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NJ
Practice Address - Zip Code:07727-3886
Practice Address - Country:US
Practice Address - Phone:732-513-4450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04301900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist