Healthcare Provider Details

I. General information

NPI: 1902710635
Provider Name (Legal Business Name): MOHAMMED SAFWAN IQBAL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

581 NY-17M
MONROE NY
10950
US

IV. Provider business mailing address

25 FRANCES LN
MONROE NY
10950-2649
US

V. Phone/Fax

Practice location:
  • Phone: 845-395-0909
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number073694
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: