MEDICARE: MR. KAZI M ANAM 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
1	183500000X	Pharmacist	030417	NY

General Provider Information

NPI Number	:	1780754697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KAZI M ANAM RPH

Provider Business Mailing Address
First Line	:	251 38TH RD
Second Line	:
City	:	LITTLE NECK
State	:	NY
Zip	:	11363-1318
Country	:	US
Telephone Number	:	718-224-1209
Fax Number	:	718-456-4983

Provider Business Practice Location Address
First Line	:	1472 DEKALB AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-3604
Country	:	US
Telephone Number	:	718-381-0018
Fax Number	:	718-456-4983

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	07/08/2007

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