Provider Demographics
NPI:1225556376
Name:MAHMOOD, REHAN N (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:REHAN
Middle Name:N
Last Name:MAHMOOD
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2965 CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:PINE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:12567-5447
Mailing Address - Country:US
Mailing Address - Phone:518-398-5588
Mailing Address - Fax:518-398-7588
Practice Address - Street 1:2965 CHURCH STREET
Practice Address - Street 2:PINE PLAINS PHARMACY
Practice Address - City:PINE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:12567-5447
Practice Address - Country:US
Practice Address - Phone:518-398-5588
Practice Address - Fax:518-398-7588
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI060595-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist