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NPI Code Detail

MEDICARE: MARYAM FARAHMAND RPH

MEDICARE: MARYAM FARAHMAND 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
1183500000XPharmacist28RI0342800NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
128RI03242800OTHERNJPHARMACY LICENSE

General Provider Information

NPI Number : 1457969529
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYAM FARAHMAND RPH
Provider Business Mailing Address
First Line : 534 21ST AVE
Second Line :
City : PATERSON
State : NJ
Zip : 07513-1337
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 534 21ST AVE
Second Line :
City : PATERSON
State : NJ
Zip : 07513-1337
Country : US
Telephone Number : 973-742-6655
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2020
Last Update Date : 07/15/2020

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Directions to “ MARYAM FARAHMAND RPH” Practice Location

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