Healthcare Provider Details

I. General information

NPI: 1770584286
Provider Name (Legal Business Name): AMIN RASHID LADHA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1043 HICKSVILLE RD
SEAFORD NY
11783-1327
US

IV. Provider business mailing address

1043 HICKSVILLE RD
SEAFORD NY
11783-1327
US

V. Phone/Fax

Practice location:
  • Phone: 516-735-2094
  • Fax: 516-735-2092
Mailing address:
  • Phone: 516-735-2094
  • Fax: 516-735-2092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18074
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: