MEDICARE: MOHAMED HAMMOUDA SOLIMAN PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	068418	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063171569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED HAMMOUDA SOLIMAN PHARMD

Provider Business Mailing Address
First Line	:	115 OVERLOOK TER
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-2715
Country	:	US
Telephone Number	:	917-470-1542
Fax Number	:

Provider Business Practice Location Address
First Line	:	2236 FOREST AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10303-1747
Country	:	US
Telephone Number	:	917-470-1542
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2021
Last Update Date	:	12/12/2021

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