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General NPI Number Information
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NPI Number | 1366073611
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Entity Type | Individual
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Provider Name | ROSA GHIAM PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/27/2020
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Last Update Date | 01/28/2020
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Provider Practice Location Address
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Address Line | 802 EASTERN PKWY
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City | BROOKLYN
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State | NY
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Zip | 11213-3506
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Country | US
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Telephone | 917-502-6240
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 SHERMAN AVE
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City | HAMDEN
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State | CT
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Zip | 06514-1363
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PC
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PCT.0014691
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License Number State | CT
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