Healthcare Provider Details

I. General information

NPI: 1215845433
Provider Name (Legal Business Name): FATIMA SALAM PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S
BRONX NY
10461-1138
US

IV. Provider business mailing address

3623 AVENUE I
BROOKLYN NY
11210-4301
US

V. Phone/Fax

Practice location:
  • Phone: 718-290-6526
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208U00000X
TaxonomyClinical Pharmacology Physician
License Number071751
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: