Provider Demographics
NPI:1093424343
Name:SYED, SHAMSUN NAHER
Entity Type:Individual
Prefix:
First Name:SHAMSUN NAHER
Middle Name:
Last Name:SYED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1125
Mailing Address - Country:US
Mailing Address - Phone:781-275-6206
Mailing Address - Fax:
Practice Address - Street 1:337 GREAT RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-2802
Practice Address - Country:US
Practice Address - Phone:781-271-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH23320183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist