Provider Demographics
NPI:1215146899
Name:HOSSAIN, MOHAMMAD AKHTER (RPH)
Entity type:Individual
Prefix:MR
First Name:MOHAMMAD
Middle Name:AKHTER
Last Name:HOSSAIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MINUTEMAN CIR
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-2709
Mailing Address - Country:US
Mailing Address - Phone:845-365-1775
Mailing Address - Fax:
Practice Address - Street 1:61 E MOUNT EDEN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-5806
Practice Address - Country:US
Practice Address - Phone:718-583-3575
Practice Address - Fax:718-583-0976
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031706183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist