Healthcare Provider Details

I. General information

NPI: 1144888934
Provider Name (Legal Business Name): RUHAMA TASNIM PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 07/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7432 BROADWAY
ELMHURST NY
11373-5609
US

IV. Provider business mailing address

4344 KISSENA BLVD APT 12C
FLUSHING NY
11355-3755
US

V. Phone/Fax

Practice location:
  • Phone: 718-426-4080
  • Fax:
Mailing address:
  • Phone: 646-436-7346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number064762
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: