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NPI Code Detail

MEDICARE: MONA HAMMAM RPH

MEDICARE:   MONA  HAMMAM  RPH
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
1183500000XPharmacist20 057179NY

General Provider Information

NPI Number : 1295135283
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONA HAMMAM RPH
Provider Business Mailing Address
First Line : 3841 18TH AVE APT 4J
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-6105
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3841 18TH AVE APT 4J
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-6105
Country : US
Telephone Number : 646-642-3393
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2014
Last Update Date : 08/27/2014

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