Provider Demographics
NPI:1194883140
Name:FOSTER MAAZ PHARMACY INC.
Entity type:Organization
Organization Name:FOSTER MAAZ PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZAHRA
Authorized Official - Middle Name:NAJUM
Authorized Official - Last Name:HUSSAINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-354-0131
Mailing Address - Street 1:1056 CONEY ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2303
Mailing Address - Country:US
Mailing Address - Phone:718-421-5533
Mailing Address - Fax:718-421-7440
Practice Address - Street 1:1056 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2303
Practice Address - Country:US
Practice Address - Phone:718-421-5533
Practice Address - Fax:718-421-7440
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DREAM PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-04
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023735183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01853727Medicaid