MEDICARE: ZAHID SAEED KHAWAJA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	015436	NY

General Provider Information

NPI Number	:	1760575054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZAHID SAEED KHAWAJA

Provider Business Mailing Address
First Line	:	4223 CHURCH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-3011
Country	:	US
Telephone Number	:	718-284-0402
Fax Number	:

Provider Business Practice Location Address
First Line	:	4223 CHURCH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-3011
Country	:	US
Telephone Number	:	718-284-0402
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	MR. ZAHID SAEED KHAWAJA
Credential	:	RPH
Telephone Number	:	718-284-0402

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	06/24/2008

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