Healthcare Provider Details

I. General information

NPI: 1124518782
Provider Name (Legal Business Name): DR. RUBIYA KABIR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 05/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 COMMUNITY DR
MANHASSET NY
11030-3816
US

IV. Provider business mailing address

300 COMMUNITY DRIVE PHARMACY DEPARTMENT
MANHASSET NY
11030
US

V. Phone/Fax

Practice location:
  • Phone: 516-562-2371
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberI053219
License Number StateNY

VII. Legacy identifiers

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

# 1
IdentifierI053219
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerNYS PHARMACY LICENSE NUMBER

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: