Healthcare Provider Details

I. General information

NPI: 1457773327
Provider Name (Legal Business Name): ADEEL KHALID PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2014
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

288 E 149TH ST
BRONX NY
10451-5630
US

IV. Provider business mailing address

288 E 149TH ST
BRONX NY
10451-5630
US

V. Phone/Fax

Practice location:
  • Phone: 347-862-4014
  • Fax: 347-862-4015
Mailing address:
  • Phone: 347-862-4014
  • Fax: 347-862-4015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number058885
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: