Provider Demographics
NPI:1124824933
Name:ELDESOUKY, AYA
Entity type:Individual
Prefix:
First Name:AYA
Middle Name:
Last Name:ELDESOUKY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 SUMMIT AVE APT 7N
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3729
Mailing Address - Country:US
Mailing Address - Phone:201-920-6483
Mailing Address - Fax:
Practice Address - Street 1:981 WESTSIDE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-6903
Practice Address - Country:US
Practice Address - Phone:201-332-0410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RJ16024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist