Provider Demographics
NPI:1093606972
Name:ABDELMESIH, MARK
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:ABDELMESIH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 JEWETT AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-2602
Mailing Address - Country:US
Mailing Address - Phone:201-238-6143
Mailing Address - Fax:
Practice Address - Street 1:2417 3RD AVE STE 406
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-6340
Practice Address - Country:US
Practice Address - Phone:347-913-4656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist