Provider Demographics
NPI:1326143025
Name:KATRI, MOUSSA (RPH)
Entity Type:Individual
Prefix:MR
First Name:MOUSSA
Middle Name:
Last Name:KATRI
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 1:2153 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-4941
Mailing Address - Country:US
Mailing Address - Phone:718-382-1233
Mailing Address - Fax:718-871-0093
Practice Address - Street 1:3814 13TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3604
Practice Address - Country:US
Practice Address - Phone:718-854-7722
Practice Address - Fax:718-871-0093
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048255183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist