Provider Demographics
NPI:1033479373
Name:RAMINFAR, BABAK
Entity Type:Individual
Prefix:
First Name:BABAK
Middle Name:
Last Name:RAMINFAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 E 35TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3439
Mailing Address - Country:US
Mailing Address - Phone:347-424-8266
Mailing Address - Fax:718-220-2112
Practice Address - Street 1:1532 E 35TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3439
Practice Address - Country:US
Practice Address - Phone:347-424-8266
Practice Address - Fax:718-220-2112
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03486700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist