MEDICARE: MR. MOHAMMAD MASOOD AHMAD PHARMACIST

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	32331	NY

General Provider Information

NPI Number	:	1760669550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MOHAMMAD MASOOD AHMAD PHARMACIST

Provider Business Mailing Address
First Line	:	5825 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3819
Country	:	US
Telephone Number	:	718-439-6360
Fax Number	:	718-492-1234

Provider Business Practice Location Address
First Line	:	5825 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3819
Country	:	US
Telephone Number	:	718-439-6360
Fax Number	:	718-492-1234

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

Provider Enumeration Date	:	01/24/2008
Last Update Date	:	01/24/2008

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