Provider Demographics
NPI:1245388305
Name:CHOWDHURY, SHAILA TAHSEEN (R PH)
Entity Type:Individual
Prefix:
First Name:SHAILA
Middle Name:TAHSEEN
Last Name:CHOWDHURY
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 RIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TOWNSHIP OF WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07676-5122
Mailing Address - Country:US
Mailing Address - Phone:201-594-0669
Mailing Address - Fax:
Practice Address - Street 1:353 EMPIRE BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-3203
Practice Address - Country:US
Practice Address - Phone:718-467-0918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044380183500000X
NJ28R102548200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist