=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811214224
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHAMSUL KARIM BAKAR R.PH.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2010
-----------------------------------------------------
Last Update Date | 04/24/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 545 SAINT PAULS PL
-----------------------------------------------------
City | BRONX
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10456-2122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-992-6881
-----------------------------------------------------
Fax | 718-992-0055
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 545 SAINT PAULS PL
-----------------------------------------------------
City | BRONX
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10456-2122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-992-6881
-----------------------------------------------------
Fax | 718-992-0055
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 044114
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------