Provider Demographics
NPI:1134279193
Name:ISKANDER, MOUSHIRA (BSC)
Entity Type:Individual
Prefix:MRS
First Name:MOUSHIRA
Middle Name:
Last Name:ISKANDER
Suffix:
Gender:F
Credentials:BSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BARDONIA MALL
Mailing Address - Street 2:
Mailing Address - City:BARDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:10954-1647
Mailing Address - Country:US
Mailing Address - Phone:845-623-8200
Mailing Address - Fax:845-623-4148
Practice Address - Street 1:4 BARDONIA MALL
Practice Address - Street 2:
Practice Address - City:BARDONIA
Practice Address - State:NY
Practice Address - Zip Code:10954-1647
Practice Address - Country:US
Practice Address - Phone:845-623-8200
Practice Address - Fax:845-623-4148
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1112700001Medicare NSC