Provider Demographics
NPI:1447433305
Name:MALIK, SYED HAMZA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:HAMZA
Last Name:MALIK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15218 UNION TPKE APT PH-G
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3921
Mailing Address - Country:US
Mailing Address - Phone:718-986-4249
Mailing Address - Fax:
Practice Address - Street 1:9108 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7910
Practice Address - Country:US
Practice Address - Phone:718-478-6078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052901183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02830284Medicaid