Provider Demographics
NPI:1609752310
Name:ERFAN, ALI TAREKTAHA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:TAREKTAHA
Last Name:ERFAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-5441
Mailing Address - Country:US
Mailing Address - Phone:917-499-5240
Mailing Address - Fax:
Practice Address - Street 1:121 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-1249
Practice Address - Country:US
Practice Address - Phone:718-524-7099
Practice Address - Fax:718-524-5700
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072963183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty