MEDICARE: MONSUR AHMED CHOWDHURY PHARM.D.

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	050290	NY

General Provider Information

NPI Number	:	1376713263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONSUR AHMED CHOWDHURY PHARM.D.

Provider Business Mailing Address
First Line	:	2903 36TH AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-3107
Country	:	US
Telephone Number	:	718-786-6611
Fax Number	:	718-786-6613

Provider Business Practice Location Address
First Line	:	2903 36TH AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-3107
Country	:	US
Telephone Number	:	718-786-6611
Fax Number	:	718-786-6613

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

Provider Enumeration Date	:	03/06/2008
Last Update Date	:	03/06/2008

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