Provider Demographics
NPI:1356486435
Name:NASIR, AFSHAN (PHARMACY)
Entity Type:Individual
Prefix:MRS
First Name:AFSHAN
Middle Name:
Last Name:NASIR
Suffix:
Gender:F
Credentials:PHARMACY
Other - Prefix:MRS
Other - First Name:AFSHAN
Other - Middle Name:
Other - Last Name:NASIR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACY
Mailing Address - Street 1:1663 METROPOLITAN AVE
Mailing Address - Street 2:BRONX
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-6202
Mailing Address - Country:US
Mailing Address - Phone:718-931-6699
Mailing Address - Fax:718-931-6699
Practice Address - Street 1:1663 METROPOLITAN AVE
Practice Address - Street 2:BRONX
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-6202
Practice Address - Country:US
Practice Address - Phone:718-931-6699
Practice Address - Fax:718-931-6699
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024709183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02067912Medicaid
NY3871780001Medicare ID - Type Unspecified