Healthcare Provider Details

I. General information

NPI: 1306410675
Provider Name (Legal Business Name): DEEDAR KARIM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1632 BRUCKNER BLVD
BRONX NY
10473-4553
US

IV. Provider business mailing address

21 BRIAN RD
EDISON NJ
08817-2303
US

V. Phone/Fax

Practice location:
  • Phone: 718-328-6777
  • Fax:
Mailing address:
  • Phone: 347-876-5776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number068155
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: