Healthcare Provider Details

I. General information

NPI: 1013597855
Provider Name (Legal Business Name): MARYAM TAHIR SEKHERY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8502 139TH ST APT 1H
BRIARWOOD NY
11435-2617
US

IV. Provider business mailing address

8502 139TH ST APT 1H
BRIARWOOD NY
11435-2617
US

V. Phone/Fax

Practice location:
  • Phone: 347-475-7427
  • Fax:
Mailing address:
  • Phone: 347-475-7427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number067267
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: