Healthcare Provider Details

I. General information

NPI: 1326656109
Provider Name (Legal Business Name): ALMUTAZBILLAH ZATER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2020
Last Update Date: 07/17/2020
Certification Date: 07/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4396 WHITE PLAINS RD
BRONX NY
10466-1413
US

IV. Provider business mailing address

4396 WHITE PLAINS RD
BRONX NY
10466-1413
US

V. Phone/Fax

Practice location:
  • Phone: 347-899-8350
  • Fax: 347-866-8352
Mailing address:
  • Phone: 347-899-8350
  • Fax: 347-899-8352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number066741
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: