MEDICARE: MAHMOOD ALAM RPH

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	183500000X	Pharmacist	034365	NY

General Provider Information

NPI Number	:	1841291994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAHMOOD ALAM RPH

Provider Business Mailing Address
First Line	:	23 WOODHILL LN
Second Line	:
City	:	GLEN HEAD
State	:	NY
Zip	:	11545-2796
Country	:	US
Telephone Number	:	516-626-3639
Fax Number	:

Provider Business Practice Location Address
First Line	:	436 ROCKAWAY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-5636
Country	:	US
Telephone Number	:	718-342-7368
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/08/2007

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