Active NPI
Ahmed Yosry Ibrahim
- Pharmacist
- Nutley, NJ
National Provider Identifier
1043661804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI03561100
- Practice address
- 100 Franklin Ave
Nutley, NJ 07110-3266 - Phone
- (973) 661-0900
- NPI assigned
- Jun 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03561100 | NJ | Primary |
Addresses
Primary practice location
100 Franklin Ave
Nutley, NJ 07110-3266
Mailing address
169 Overmount Ave
Apt B
Woodland Park, NJ 07424-3232
Phone (201) 655-8461
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03561100 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466640000000",
"number": "1043661804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 OVERMOUNT AVE",
"address_2": "APT B",
"city": "WOODLAND PARK",
"state": "NJ",
"postal_code": "074243232",
"telephone_number": "201-655-8461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 FRANKLIN AVE",
"city": "NUTLEY",
"state": "NJ",
"postal_code": "071103266",
"telephone_number": "973-661-0900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHIM",
"first_name": "AHMED",
"middle_name": "YOSRY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-23",
"last_updated": "2016-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03561100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nutley, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.