Provider Demographics
NPI:1225350093
Name:BHUIYAN, MOHAMMED SANAUL HOQUE (RPH)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:SANAUL HOQUE
Last Name:BHUIYAN
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 1:57 EAST KINGSBRIDGE RD
Mailing Address - Street 2:STAR DRUG
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468
Mailing Address - Country:US
Mailing Address - Phone:718-295-4444
Mailing Address - Fax:718-367-9797
Practice Address - Street 1:57 E KINGSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-7503
Practice Address - Country:US
Practice Address - Phone:718-295-4444
Practice Address - Fax:718-367-9797
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30089183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02834637Medicaid