Provider Demographics
NPI:1407074248
Name:FIRDOUSHI, ZANNATUL (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:ZANNATUL
Middle Name:
Last Name:FIRDOUSHI
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:ZANNATUL
Other - Middle Name:
Other - Last Name:FIRDOUSHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:2134 STARLING AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4303
Mailing Address - Country:US
Mailing Address - Phone:201-707-5704
Mailing Address - Fax:
Practice Address - Street 1:2134 STARLING AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-4303
Practice Address - Country:US
Practice Address - Phone:201-707-5704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02815100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist