Healthcare Provider Details

I. General information

NPI: 1720997190
Provider Name (Legal Business Name): SUMAN MAHMOOD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 DELAWARE AVE
DELMAR NY
12054-1123
US

IV. Provider business mailing address

19 EVERETT RD
ALBANY NY
12205-1437
US

V. Phone/Fax

Practice location:
  • Phone: 518-439-9356
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number074422
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: