MEDICARE: MAZHARUL AHMED

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	052800	NY

General Provider Information

NPI Number	:	1255654836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAZHARUL AHMED

Provider Business Mailing Address
First Line	:	472 72ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-1605
Country	:	US
Telephone Number	:	718-909-2709
Fax Number	:

Provider Business Practice Location Address
First Line	:	379 MYRTLE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11205-2407
Country	:	US
Telephone Number	:	718-403-9112
Fax Number	:

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

Provider Enumeration Date	:	03/10/2010
Last Update Date	:	09/15/2015

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Directions to “ MAZHARUL AHMED ” Practice Location

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