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General NPI Number Information
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NPI Number | 1578047296
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Entity Type | Individual
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Provider Name | SANAULLAH MEHIRDEL PHARM. D
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Gender | Male
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 2112 WHITE PLAINS RD
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City | BRONX
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State | NY
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Zip | 10462-1404
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Country | US
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Telephone | 718-597-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 15036 20TH RD FL 1
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City | WHITESTONE
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State | NY
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Zip | 11357-3602
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Country | US
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Telephone | 718-223-3692
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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 | 063884
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License Number State | NY
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