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NPI Code Detail

MEDICARE: DR. AMNA FAZAL PHARMD

MEDICARE: DR. AMNA FAZAL PHARMD
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
1183500000XPharmacist053851NY

General Provider Information

NPI Number : 1851614549
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMNA FAZAL PHARMD
Provider Business Mailing Address
First Line : 482 BARLOW AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10308-1205
Country : US
Telephone Number : 917-922-2053
Fax Number :
Provider Business Practice Location Address
First Line : 2045 FOREST AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10303-1734
Country : US
Telephone Number : 718-982-8019
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2010
Last Update Date : 03/09/2010

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