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General NPI Number Information
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NPI Number | 1972028819
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Entity Type | Organization
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Legal Business Name | HOSAM INC
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Dates
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Enumeration Date | 08/11/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 210 PARKSIDE AVE
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City | BROOKLYN
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State | NY
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Zip | 11226-1367
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Country | US
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Telephone | 718-513-6657
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Fax |
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Provider Business Mailing Address
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Address Line | 210 PARKSIDE AVE
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City | BROOKLYN
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State | NY
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Zip | 11226-1367
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Country | US
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Telephone | 718-513-6657
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Fax |
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Authorized Official
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Title or Position | OWNER/SUPERVISING PHARMACIST
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Name | DR. HOSAM ELSAYYAD
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Credential | PHARM.D.
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Telephone | 646-620-6003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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