Provider Demographics
NPI:1538476528
Name:JAWAID, AMBAREEN (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:AMBAREEN
Middle Name:
Last Name:JAWAID
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:AMBAREEN
Other - Middle Name:
Other - Last Name:SIDDIQUI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:6901 NORTHERN BLVD APT 6F
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-2207
Mailing Address - Country:US
Mailing Address - Phone:718-397-5044
Mailing Address - Fax:
Practice Address - Street 1:6901 NORTHERN BLVD APT 6F
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-2207
Practice Address - Country:US
Practice Address - Phone:718-397-5044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-12
Last Update Date:2010-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051235183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist