Provider Demographics
NPI:1912738196
Name:ELSHARBATLY, ROWAN SHOKRY HASSAN ALI (RPH)
Entity type:Individual
Prefix:
First Name:ROWAN
Middle Name:SHOKRY HASSAN ALI
Last Name:ELSHARBATLY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 NOSTRAND AVE APT 1G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2121
Mailing Address - Country:US
Mailing Address - Phone:347-681-8723
Mailing Address - Fax:
Practice Address - Street 1:3901 NOSTRAND AVE APT 1G
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2121
Practice Address - Country:US
Practice Address - Phone:347-681-8723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071675183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist