MEDICARE: DR. AISHA MUMTAZ MUHAMMED RPH, PHARMD

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	040934	NY

General Provider Information

NPI Number	:	1861052847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AISHA MUMTAZ MUHAMMED RPH, PHARMD

Provider Business Mailing Address
First Line	:	127 OLIVER AVE
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11580-1623
Country	:	US
Telephone Number	:	516-476-4515
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 E 116TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-1128
Country	:	US
Telephone Number	:	212-348-7788
Fax Number	:

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

Provider Enumeration Date	:	06/20/2019
Last Update Date	:	06/20/2019

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