Provider Demographics
NPI:1497087613
Name:ALAM, MOHAMMED SAFIUL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:SAFIUL
Last Name:ALAM
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 1:4 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5339
Mailing Address - Country:US
Mailing Address - Phone:212-683-5532
Mailing Address - Fax:212-532-8310
Practice Address - Street 1:4 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5339
Practice Address - Country:US
Practice Address - Phone:212-683-5532
Practice Address - Fax:212-532-8310
Is Sole Proprietor?:No
Enumeration Date:2010-02-13
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053821183500000X
CTPCT.0011706183500000X
NJ28RI03485700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist