Provider Demographics
NPI:1124609177
Name:BASHER, RAHAB S (PHARMD)
Entity type:Individual
Prefix:
First Name:RAHAB
Middle Name:S
Last Name:BASHER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4820 46TH ST APT A4
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-7116
Mailing Address - Country:US
Mailing Address - Phone:347-239-0327
Mailing Address - Fax:
Practice Address - Street 1:3526 FRANCIS LEWIS BLVD
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:NY
Practice Address - Zip Code:11358-1954
Practice Address - Country:US
Practice Address - Phone:718-353-1571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist