Provider Demographics
NPI:1174213011
Name:ABISKHIROON, AMIRA KAMAL (PHARMACIST)
Entity type:Individual
Prefix:
First Name:AMIRA
Middle Name:KAMAL
Last Name:ABISKHIROON
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:AMIRA
Other - Middle Name:KAMAL
Other - Last Name:ABISKHIROON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:2196 CRAVEN LN
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-3248
Mailing Address - Country:US
Mailing Address - Phone:804-300-1079
Mailing Address - Fax:
Practice Address - Street 1:2196 CRAVEN LN
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-3248
Practice Address - Country:US
Practice Address - Phone:804-300-1079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202221096183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist