Provider Demographics
NPI:1124147251
Name:JAFORPUR INC.
Entity type:Organization
Organization Name:JAFORPUR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:KABIR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-206-9333
Mailing Address - Street 1:8039 236TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2123
Mailing Address - Country:US
Mailing Address - Phone:718-464-8126
Mailing Address - Fax:
Practice Address - Street 1:16843 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4440
Practice Address - Country:US
Practice Address - Phone:718-206-9333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02478577Medicaid
NY4950390001Medicare NSC