Provider Demographics
NPI:1306468921
Name:ELSAYED, OMAR ADNAN AHMED BEKHIT (RPH)
Entity type:Individual
Prefix:
First Name:OMAR
Middle Name:ADNAN AHMED BEKHIT
Last Name:ELSAYED
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 1:255 AUDUBON AVE APT 2B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-7344
Mailing Address - Country:US
Mailing Address - Phone:917-858-0777
Mailing Address - Fax:
Practice Address - Street 1:255 AUDUBON AVE APT 2B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-7344
Practice Address - Country:US
Practice Address - Phone:917-858-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04091600183500000X
NY068543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist