Provider Demographics
NPI:1356817779
Name:SALEEM, MUHAMMAD USMAN
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:USMAN
Last Name:SALEEM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 ELECTRIC ST
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18509-2120
Mailing Address - Country:US
Mailing Address - Phone:570-677-6331
Mailing Address - Fax:
Practice Address - Street 1:335 BEAR HILL RD
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1006
Practice Address - Country:US
Practice Address - Phone:877-334-1610
Practice Address - Fax:877-334-1612
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH100003399183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist