Provider Demographics
NPI:1194995795
Name:ABDELAZIZ, GHASSAN WAJEEH (PHARM D)
Entity type:Individual
Prefix:DR
First Name:GHASSAN
Middle Name:WAJEEH
Last Name:ABDELAZIZ
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3836
Mailing Address - Country:US
Mailing Address - Phone:718-765-0019
Mailing Address - Fax:718-765-0032
Practice Address - Street 1:5805 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3836
Practice Address - Country:US
Practice Address - Phone:718-765-0019
Practice Address - Fax:718-765-0032
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050882183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist