Provider Demographics
NPI:1194047779
Name:RAGAB, OSAMA AHMED (RPH)
Entity type:Individual
Prefix:MR
First Name:OSAMA
Middle Name:AHMED
Last Name:RAGAB
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 1:239 94TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6807
Mailing Address - Country:US
Mailing Address - Phone:718-996-6984
Mailing Address - Fax:
Practice Address - Street 1:677 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-1240
Practice Address - Country:US
Practice Address - Phone:718-499-7410
Practice Address - Fax:718-499-7423
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist