Healthcare Provider Details

I. General information

NPI: 1558684555
Provider Name (Legal Business Name): SAYEDUL HOQUE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2010
Last Update Date: 03/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 BEVERLEY RD
BROOKLYN NY
11218-3914
US

IV. Provider business mailing address

114 BEVERLEY RD
BROOKLYN NY
11218-3914
US

V. Phone/Fax

Practice location:
  • Phone: 718-437-7802
  • Fax: 718-437-7808
Mailing address:
  • Phone: 718-437-7802
  • Fax: 718-437-7808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number048995
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: