Provider Demographics
NPI:1780962548
Name:ABDELMACKSOUD, DALIA M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DALIA
Middle Name:M
Last Name:ABDELMACKSOUD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 11TH ST
Mailing Address - Street 2:APT.O
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5261
Mailing Address - Country:US
Mailing Address - Phone:917-204-7217
Mailing Address - Fax:
Practice Address - Street 1:618 11TH ST
Practice Address - Street 2:APT.O
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5261
Practice Address - Country:US
Practice Address - Phone:917-204-7217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043893183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist