Provider Demographics
NPI:1104149814
Name:GHALY, ZARIF E
Entity type:Individual
Prefix:MR
First Name:ZARIF
Middle Name:E
Last Name:GHALY
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 1:244 KELLY BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6009
Mailing Address - Country:US
Mailing Address - Phone:917-834-2806
Mailing Address - Fax:718-477-3770
Practice Address - Street 1:341 9TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4007
Practice Address - Country:US
Practice Address - Phone:718-499-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051294-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY702767090OtherDEPARTMENT OF MOTOR VEHICLES