Provider Demographics
NPI:1538491154
Name:HOSAIN-BHUIYAN, MOHAMMED DAUD
Entity Type:Individual
Prefix:MR
First Name:MOHAMMED
Middle Name:DAUD
Last Name:HOSAIN-BHUIYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-2407
Mailing Address - Country:US
Mailing Address - Phone:845-268-2065
Mailing Address - Fax:
Practice Address - Street 1:24 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5567
Practice Address - Country:US
Practice Address - Phone:718-392-8049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-07
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02769400183500000X
NY049480183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist