MEDICARE: BISMILLAH 1 CORPORATION

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	3336C0003X	Community/Retail Pharmacy	032397	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2143253	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831529122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BISMILLAH 1 CORPORATION

Provider Business Mailing Address
First Line	:	2992 FULTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-1124
Country	:	US
Telephone Number	:	718-827-8943
Fax Number	:	718-827-8195

Provider Business Practice Location Address
First Line	:	2992 FULTON ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-1124
Country	:	US
Telephone Number	:	718-827-8943
Fax Number	:	718-827-8195

Authorized Official
Title or Position	:	OWNER
Name	:	MAHMOOD NAQVI
Credential	:
Telephone Number	:	718-827-8943

Provider Enumeration Date	:	11/22/2013
Last Update Date	:	12/01/2022

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Directions to “BISMILLAH 1 CORPORATION ” Practice Location

Language	Start Address	Practice Location

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