Healthcare Provider Details

I. General information

NPI: 1285804591
Provider Name (Legal Business Name): MOHAMMAD SALEEM R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 5TH AVE SUITE J 268
NEW YORK NY
10001-7604
US

IV. Provider business mailing address

244 5TH AVE SUITE J 268
NEW YORK NY
10001-7604
US

V. Phone/Fax

Practice location:
  • Phone: 212-561-9445
  • Fax: 212-591-6046
Mailing address:
  • Phone: 212-561-9445
  • Fax: 212-591-6046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number032728
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: