Healthcare Provider Details

I. General information

NPI: 1073942025
Provider Name (Legal Business Name): MALEEHA TAHIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2013
Last Update Date: 11/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 EASTCHESTER RD
BRONX NY
10461-2301
US

IV. Provider business mailing address

653 HOWARD ST
TEANECK NJ
07666-5329
US

V. Phone/Fax

Practice location:
  • Phone: 718-904-2838
  • Fax:
Mailing address:
  • Phone: 201-357-2488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number050672
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: