MEDICARE: REBECCA Y AMIRZADEH

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	069889	NY

General Provider Information

NPI Number	:	1346953189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA Y AMIRZADEH

Provider Business Mailing Address
First Line	:	1517 E 28TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1801
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	306 CLARKSON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-2204
Country	:	US
Telephone Number	:	718-902-8871
Fax Number	:

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

Provider Enumeration Date	:	12/26/2022
Last Update Date	:	12/26/2022

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Directions to “ REBECCA Y AMIRZADEH ” Practice Location

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