Provider Demographics
NPI:1356824536
Name:SARKER, NAZMUL HASSAN
Entity Type:Individual
Prefix:
First Name:NAZMUL
Middle Name:HASSAN
Last Name:SARKER
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 1:1342 HERSCHELL ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3623
Mailing Address - Country:US
Mailing Address - Phone:347-609-1988
Mailing Address - Fax:
Practice Address - Street 1:636 6TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4228
Practice Address - Country:US
Practice Address - Phone:212-255-5291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064671183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY064671OtherNEW YORK BOARD OF PHARMACY