Provider Demographics
NPI:1720079817
Name:TEHFE, MAHMOUD H (RPH)
Entity Type:Individual
Prefix:MR
First Name:MAHMOUD
Middle Name:H
Last Name:TEHFE
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 1:1326 BAY RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-2211
Mailing Address - Country:US
Mailing Address - Phone:718-597-3380
Mailing Address - Fax:718-597-0094
Practice Address - Street 1:662 MORRIS PARK AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-3503
Practice Address - Country:US
Practice Address - Phone:718-597-3380
Practice Address - Fax:718-597-0094
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043545183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist