Healthcare Provider Details

I. General information

NPI: 1598932485
Provider Name (Legal Business Name): MR. AZIZUL HOQUE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2008
Last Update Date: 04/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8254 247TH ST
BELLEROSE NY
11426-1717
US

IV. Provider business mailing address

8254 247TH ST
BELLEROSE NY
11426-1717
US

V. Phone/Fax

Practice location:
  • Phone: 718-468-6069
  • Fax:
Mailing address:
  • Phone: 718-468-6069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number043714
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: