Provider Demographics
NPI:1417124397
Name:TARIQ, ARSHAD (RPH)
Entity Type:Individual
Prefix:MR
First Name:ARSHAD
Middle Name:
Last Name:TARIQ
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 1:8416 165TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1902
Mailing Address - Country:US
Mailing Address - Phone:718-526-6760
Mailing Address - Fax:
Practice Address - Street 1:1514 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-4554
Practice Address - Country:US
Practice Address - Phone:212-360-6969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-10
Last Update Date:2008-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049675183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00927564Medicaid