=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699599308
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SIDRAH FATIMA SYED PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2024
-----------------------------------------------------
Last Update Date | 11/09/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 370 WHITE PLAINS RD
-----------------------------------------------------
City | EASTCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10709-2804
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-771-5853
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2717 KINGSLAND AVE
-----------------------------------------------------
City | BRONX
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10469-6113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 072076
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------