Provider Demographics
NPI:1396519351
Name:GHANI, NAFISUL (PHARMD)
Entity type:Individual
Prefix:
First Name:NAFISUL
Middle Name:
Last Name:GHANI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144-5111
Mailing Address - Country:US
Mailing Address - Phone:518-203-9294
Mailing Address - Fax:
Practice Address - Street 1:1645 COLUMBIA TPKE
Practice Address - Street 2:
Practice Address - City:CASTLETON
Practice Address - State:NY
Practice Address - Zip Code:12033-9535
Practice Address - Country:US
Practice Address - Phone:518-477-8166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy