MEDICARE: ALI RAZA

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	37895	SC
2	183500000X	Pharmacist	066376	NY

General Provider Information

NPI Number	:	1295218055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALI RAZA

Provider Business Mailing Address
First Line	:	820 WYCKOFF AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-6005
Country	:	US
Telephone Number	:	718-456-3156
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 WYCKOFF AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-6005
Country	:	US
Telephone Number	:	718-456-3156
Fax Number	:

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

Provider Enumeration Date	:	09/07/2018
Last Update Date	:	08/19/2024

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Directions to “ ALI RAZA ” Practice Location

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