Individual provider Active NPI

Abdelkarim Hassan Eisa

  • Pharmacist
  • Dayton, OH
National Provider Identifier
1033813324
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03442757 Issued in OH
Practice address
360 Mapletrace TRL
Dayton, OH 45458-9450
Phone
(202) 631-1505
NPI assigned
Mar 29, 2023
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03442757 OH Primary

Addresses

Primary practice location

360 Mapletrace TRL
Dayton, OH 45458-9450

Mailing address

360 Mapletrace TRL
Dayton, OH 45458-9450
Phone (202) 631-1505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
03442757OHMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1033813324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MAPLETRACE TRL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454589450",
            "telephone_number": "202-631-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MAPLETRACE TRL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454589450",
            "telephone_number": "202-631-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISA",
        "first_name": "ABDELKARIM",
        "middle_name": "HASSAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03442757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.