Provider Demographics
NPI:1740931385
Name:AHMAD, SUNNA
Entity type:Individual
Prefix:
First Name:SUNNA
Middle Name:
Last Name:AHMAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3979
Mailing Address - Country:US
Mailing Address - Phone:609-315-1324
Mailing Address - Fax:
Practice Address - Street 1:71 SPRINGSIDE RD
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-9613
Practice Address - Country:US
Practice Address - Phone:609-871-9100
Practice Address - Fax:609-880-0286
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04011100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist