Basic Information
| Provider Information | |||||||||
| NPI: | 1528144987 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AHRENS | ||||||||
| FirstName: | EDWARD | ||||||||
| MiddleName: | I | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | R.PH. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1309 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100280010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9176126057 | ||||||||
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| Practice Location | |||||||||
| Address1: | 211 E 79TH ST | ||||||||
| Address2: | 2ND FLOOR PHARMACY | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100210819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125177347 | ||||||||
| FaxNumber: | 2128794594 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835G0303X | 033932 | NY | Y | Pharmacy Service Providers | Pharmacist | Geriatric |
No ID Information.